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European Spine Journal

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01-12-2018 | Original Article

Hounsfield units as predictor for cage subsidence and loss of reduction: following posterior-anterior stabilization in thoracolumbar spine fractures

Authors: Bernhard Wilhelm Ullrich, Philipp Schenk, Ulrich J. Spiegl, Thomas Mendel, Gunther Olaf Hofmann

Published in: European Spine Journal | Issue 12/2018

Abstract

Study design

A retrospective, longitudinal cohort study.

Objective

The purpose of this study was to examine whether Hounsfield units (HUs), as an alternative bone mineral density measurement to dual-energy X-ray absorptiometry and quantitative computed tomography, which lead to additional radiation exposure for patients, has an effect on the maintenance of reduction in bisegmental Cobb angle (CA) and cage subsidence in patients who receive bisegmental spine stabilization after traumatic thoracolumbar spine fractures.

Methods

A total of 81 patients with a mean follow-up of 12 months were analyzed. CAs and cage subsidence were measured intraoperatively and at follow-up. HU was measured, and patients were subsequently assigned based on HU to three HU subgroups (group 1: HU < 110 [poor bone quality (BQ)]; group 2: HU 180–110 [diminished BQ]; group 3: HU > 180 [good BQ]).

Results

Following anterior stabilization, loss of reduction and cage subsidence differed between patients with poor and diminished BQ but not significantly, and both groups showed significantly more loss of reduction and cage subsidence than patients with good BQ.

Conclusion

BQ, estimated with HU, had significant effects on cage subsidence and loss of reduction. We recommend measuring HU before surgery and applying additional treatment strategies, such as polymethylmethacrylate augmentation of endplates or anterior plates, for patients with HU < 180.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Available only for authorised users

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Title: Hounsfield units as predictor for cage subsidence and loss of reduction: following posterior-anterior stabilization in thoracolumbar spine fractures
Authors: Bernhard Wilhelm Ullrich
Philipp Schenk
Ulrich J. Spiegl
Thomas Mendel
Gunther Olaf Hofmann
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 12/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-018-5792-9

At a glance: The STEP trials

Springer Medicine

Hounsfield units as predictor for cage subsidence and loss of reduction: following posterior-anterior stabilization in thoracolumbar spine fractures

Abstract

Study design

Objective

Methods

Results

Conclusion

Graphical abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Study design

Objective

Methods

Results

Conclusion

Graphical abstract

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