Satisfactory 2-year outcome of minimal invasive hybrid stabilization with double treated screws for unstable osteoporotic spinal fractures.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-30 DOI:10.1007/s00068-024-02645-1

Mohamad Agha Mahmoud, Anas Afifi, Maher Ghandour, Ümit Mert, Christian Herren, Christian Blume, Miguel Pishnamaz, Frank Hildebrand, Stavros Oikonomidis, Rolf Sobottke, Michel Teuben

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Abstract

Purpose: This study evaluates whether the fracture level alters the outcomes of minimally invasive hybrid stabilization (MIHS) with double-threaded, uncemented polyaxial screws for unstable osteoporotic vertebral fractures.

Methods: This prospective cohort study included 73 patients (71.23% females, mean age: 79.9 ± 8.8 years) with unstable OF 3-4 fractures treated by MIHS between Nov 2015-Jan 2018. Patient characteristics, operative data, clinical outcomes, complications, radiological outcomes, and midterm (24-month) follow-up regarding functionality, pain, and quality of life were analyzed.

Results: Patients had thoracolumbar (71.23%), thoracic (10.97%), and lumbar (17.8%) fractures. Operative time was < 120 min in 73.97% of patients, with blood loss < 500 ml in 97.25% of cases. No in-hospital mortality was recorded. Spine-associated complications occurred in 15.07% of patients, while 36.98% of patients had urinary tract infections (n = 12), pneumonia (n = 5), and electrolyte disturbances (n = 9). The mean length of hospital stay was 13.38 ± 7.20 days. Clinically-relevant screw loosening occurred in 1.7% of screws, and secondary adjacent fractures were diagnosed in 5.48% of patients. The alpha-angle improved significantly postoperatively (mean change: 5.4°) and remained stable for 24 months. The beta-angle improved significantly from 16.3° ± 7.5 to 10.8° ± 5.6 postoperatively but increased slightly to 14.1° ± 6.2 at midterm follow-up. Although no differences were seen regarding baseline data, clinical outcomes, and complications, fracture level significantly altered the COMI score at 24 months with no effect on pain score or quality-of-life.

Conclusion: MIHS using polyaxial screws is a safe treatment for single-level osteoporotic spinal fractures. Fracture level did not alter radiological reduction loss; however, it significantly altered patients' function at 24 months.

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不稳定型骨质疏松性脊柱骨折的双治疗螺钉微创混合稳定术两年后疗效令人满意。

目的：本研究评估了骨折水平是否会改变使用双螺纹非骨水泥多轴螺钉微创混合稳定（MIHS）治疗不稳定骨质疏松性脊椎骨折的结果：这项前瞻性队列研究纳入了2015年11月至2018年1月期间接受MIHS治疗的73例不稳定OF 3-4骨折患者（71.23%为女性，平均年龄：79.9 ± 8.8岁）。研究分析了患者特征、手术数据、临床结果、并发症、放射学结果，以及有关功能、疼痛和生活质量的中期（24个月）随访：患者有胸腰椎（71.23%）、胸椎（10.97%）和腰椎（17.8%）骨折。手术时间使用多轴螺钉的MIHS是治疗单水平骨质疏松性脊柱骨折的一种安全方法。骨折水平不会改变放射学缩小损失，但会显著改变患者 24 个月后的功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.