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Published in: European Journal of Trauma and Emergency Surgery 3/2021

01-06-2021 | Original Article

Clinical and radiological evaluation of thoracic spine fractures with or without sternal fracture: is there a need for ventral stabilization?

Authors: Thomas Weiß, Isabella Klöpfer-Krämer, Stefan Hauck, Oliver Gonschorek, Florian Högel

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2021

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Abstract

Objective

The treatment of thoracic spine (TS) fractures with additional sternal fractures compared to TS fractures without sternal fractures is discussed controversionally, because in some studies it was stated that sternal fractures decrease the thoracic stability. We hypothesized that both types of fractures can be treated the same way by posterior stabilization alone.

Methods

A total number of 69 patients with thoracic fractures, with or without additional sternal fractures, were examined, regarding the angle of kyphosis after fracture, postoperatively and after 6 and 12 months. We also recorded the outcome using the Odom’s score and the time until patients returned to work and the activity level.

Results

It was found that the angle of kyphosis was nearly physiological after stabilization in both groups and a loss of reduction after 1 year was also comparable, either in the patients suffering from the additional sternal fracture or not. In addition, the Odom’s score and the time until return to work and the activity level were comparable in both groups.

Conclusion

We did not find any arguments to preserve additional anterior stabilization or reasons for different treatment strategies either additional sternal fractures occur in thoracic spine fractures or not.
Literature
1.
go back to reference White AA, Panjabi MM. Clinical biomechanics of the spine. Philadelphia: Lippincott Williams & Wilkins; 1990. White AA, Panjabi MM. Clinical biomechanics of the spine. Philadelphia: Lippincott Williams & Wilkins; 1990.
2.
go back to reference Busscher I, van Dieen JH, Kingma I, van der Veen AJ, Verkerke GJ, Veldhuizen AG. Biomechanical characteristics of different region of the human spine: an in vitro study on multilevel spinal segments. Spine. 2009;34:2858–64.CrossRef Busscher I, van Dieen JH, Kingma I, van der Veen AJ, Verkerke GJ, Veldhuizen AG. Biomechanical characteristics of different region of the human spine: an in vitro study on multilevel spinal segments. Spine. 2009;34:2858–64.CrossRef
3.
go back to reference Fujimori T, Iwasaki M, Nagamoto Y, Ishii T, Kashii M, Murase T, et al. Kinematics of the thoracic spine in trunk rotation: in vivo 3-dimensional analysis. Spine. 2012;37:E1318–E13281328.CrossRef Fujimori T, Iwasaki M, Nagamoto Y, Ishii T, Kashii M, Murase T, et al. Kinematics of the thoracic spine in trunk rotation: in vivo 3-dimensional analysis. Spine. 2012;37:E1318–E13281328.CrossRef
4.
go back to reference Masharawi Y, Rothschild B, Dar G, Peleg S, Robinson D, Been E, et al. Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis. Spine. 2004;29:1755–63.CrossRef Masharawi Y, Rothschild B, Dar G, Peleg S, Robinson D, Been E, et al. Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis. Spine. 2004;29:1755–63.CrossRef
5.
go back to reference Oda I, Abumi K, Lü D, Shono Y, Kaneda K. Biomechanical role of the posterior elements, costovertebral joints, and rib cage in the stability of the thoracic spine. Spine. 1996;21:1423–9.CrossRef Oda I, Abumi K, Lü D, Shono Y, Kaneda K. Biomechanical role of the posterior elements, costovertebral joints, and rib cage in the stability of the thoracic spine. Spine. 1996;21:1423–9.CrossRef
6.
go back to reference Briggs AM, van Dieen JH, Wrigley TV, Greig AM, Phillips B, Lo SK, et al. Thoracic kyphosis affects spinal loads and trunk muscle force. Phys Ther. 2007;87:595–607.CrossRef Briggs AM, van Dieen JH, Wrigley TV, Greig AM, Phillips B, Lo SK, et al. Thoracic kyphosis affects spinal loads and trunk muscle force. Phys Ther. 2007;87:595–607.CrossRef
7.
go back to reference Horton WC, Kraiwattanapong C, Akamaru T, Minamide A, Park JS, Park MS, Hutton WC. The role of the sternum, costosternal articulations, intervertebral disc, and facets in thoracic sagittal plane biomechanics: a comparison of three different sequences of surgical release. Spine (Phila Pa 1976). 2005;30(18):2014–23.CrossRef Horton WC, Kraiwattanapong C, Akamaru T, Minamide A, Park JS, Park MS, Hutton WC. The role of the sternum, costosternal articulations, intervertebral disc, and facets in thoracic sagittal plane biomechanics: a comparison of three different sequences of surgical release. Spine (Phila Pa 1976). 2005;30(18):2014–23.CrossRef
9.
go back to reference Krinner S, Grupp S, Oppel P, Langenbach A, Hennig FF, Schulz-Drost S. Do low profile implants provide reliable stability in fixing the sternal fractures as a "fourth vertebral column" in sternovertebral injuries? J Thorac Dis. 2017;9(4):1054–64. 10.21037/jtd.2017.03.37. Krinner S, Grupp S, Oppel P, Langenbach A, Hennig FF, Schulz-Drost S. Do low profile implants provide reliable stability in fixing the sternal fractures as a "fourth vertebral column" in sternovertebral injuries? J Thorac Dis. 2017;9(4):1054–64. 10.21037/jtd.2017.03.37.
12.
go back to reference McLain RF. Functional outcomes after surgery for spinal fractures: return to work and activity. Spine (Phila Pa 1976). 2004;29(4):470–7.CrossRef McLain RF. Functional outcomes after surgery for spinal fractures: return to work and activity. Spine (Phila Pa 1976). 2004;29(4):470–7.CrossRef
Metadata
Title
Clinical and radiological evaluation of thoracic spine fractures with or without sternal fracture: is there a need for ventral stabilization?
Authors
Thomas Weiß
Isabella Klöpfer-Krämer
Stefan Hauck
Oliver Gonschorek
Florian Högel
Publication date
01-06-2021
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 3/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-019-01280-5

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