Biomechanics and clinical outcome after posterior stabilization of mid-thoracic vertebral body fractures: a systematic literature review

Spiegl, Ulrich J., Osterhoff, Georg, Bula, Philipp, Hartmann, Frank, Scheyerer, Max J., Schnake, Klaus J. and Ullrich, Bernhard W. . Biomechanics and clinical outcome after posterior stabilization of mid-thoracic vertebral body fractures: a systematic literature review. Eur. J. Trauma Emerg. Surg.. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1863-9941

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DOI:10.1007/s00068-020-01560-5

Abstract

Purpose The aim of this review is to systematically screen the literature for clinical and biomechanical studies dealing with posterior stabilization of acute traumatic mid-thoracic vertebral fractures in patients with normal bone quality. Methods This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications up to December 2018 dealing with the posterior stabilization of fractures of the mid-thoracic spine. Results Altogether, 1012 articles were retrieved from the literature search. A total of 960 articles were excluded. A total of 16 articles were dealing with the timing of surgery in polytraumatized patients, patients suffering of neurologic deficits after midthoracic fractures, and the impact of concomitant thoracic injuries and were excluded. Thus, 36 remaining original articles were included in this systematic review depicting the topics biomechanics, screw insertion, and outcome after posterior stabilization. The overall level of evidence of the vast majority of studies is low. Conclusion High quality studies are lacking. Long-segmental stabilization is indicated in unstable midthoracic fractures with concomitant sternal fractures. Generally, long-segmental constructs seem to be the safer treatment strategy considering the relative high penetration rate of pedicle screws in this region. Thereby, navigated insertion techniques and intraoperative 3D-imaging help to improve pedicle screw placement accuracy.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Spiegl, Ulrich J.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Osterhoff, Georg	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Bula, Philipp	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Hartmann, Frank	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Scheyerer, Max J.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Schnake, Klaus J.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Ullrich, Bernhard W.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED