Spiegl, Ulrich J. A., Schnake, Klaus John, Hartmann, Frank, Katscher, Sebastian, Riehle, Marion, Scheyerer, Max J., Schmeiser, Gregor, Siekmann, Holger and Osterhoff, Georg (2021). Traumatic Fractures of the Thoracic Spine: Narrative Literature Review. Z. Orthop. Unfallchir., 159 (4). S. 373 - 383. NEW YORK: THIEME MEDICAL PUBL INC. ISSN 1864-6743

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Abstract

The majority of traumatic vertebral fractures occur at the thoracolumbar junction and the lumbar spine and less commonly at the mid-thoracic and upper thoracic spine. In accordance, a high number of articles are dealing with thoracolumbar fractures focusing on the thoracolumbar junction. Nonetheless, the biomechanics of the thoracic spine differ from the thoracolumbar junction and the lumbar vertebral spine. The aim of this review is to screen the literature dealing with acute traumatic thoracic vertebral fractures in patients with normal bone quality. Thereby, the diagnostic of thoracic vertebral body fractures should include a CT examination. Ideally, the CT should include the whole thoracic cage particularly in patients suffering high energy accidents or in those with clinical suspicion of concomitant thoracic injuries. Generally, concomitant thoracic injuries are frequently seen in patients with thoracic spine fractures. Particularly sternal fractures cause an increase in fracture instability. In case of doubt, long segment stabilization is recommended in patients with unstable mid- und upper thoracic fractures, particularly in those patients with a high grade of instability. Zusammenfassung Die meisten Publikationen, die sich mit nicht zervikalen Wirbelkorperfrakturen befassen, schlie ss en die gesamte thorakolumbale Wirbelsaule ein und erfassen dabei hauptsachlich Frakturen des thorakolumbalen ubergangs und der Lendenwirbelsaule, sodass Frakturen der mittleren und oberen Brustwirbelsaule unterprasentiert sind. Dagegen unterscheidet sich die Biomechanik der Brustwirbelsaule erheblich von der des thorakolumbalen ubergangs und der Lendenwirbelsaule. Dieses Review befasst sich mit der Literatur, die sich isoliert mit traumatischen Frakturen der Brustwirbelsaule beschaftigt. Dabei zeigt sich, dass die Diagnostik eine CT einschlie ss lich der umgebenden Strukturen beinhalten sollte, da Begleitverletzungen am Thorax sehr haufig sind. Insbesondere zusatzliche Sternumfrakturen erhohen den Grad der Instabilitat. Der Goldstandard der Versorgung sollte insbesondere bei Frakturen mit hohem Grad an Instabilitat die langstreckige dorsale Stabilisierung sein.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Spiegl, Ulrich J. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schnake, Klaus JohnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hartmann, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Katscher, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riehle, MarionUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scheyerer, Max J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmeiser, GregorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Siekmann, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Osterhoff, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-594086
DOI: 10.1055/a-1144-3846
Journal or Publication Title: Z. Orthop. Unfallchir.
Volume: 159
Number: 4
Page Range: S. 373 - 383
Date: 2021
Publisher: THIEME MEDICAL PUBL INC
Place of Publication: NEW YORK
ISSN: 1864-6743
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
THORACOLUMBAR BURST FRACTURES; INJURY CLASSIFICATION-SYSTEM; ANTERIOR-ONLY STABILIZATION; PEDICLE SCREWS; NONOPERATIVE TREATMENT; SURGICAL-TREATMENT; STERNAL FRACTURES; LUMBAR SPINE; FIXATION; PLACEMENTMultiple languages
OrthopedicsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/59408

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