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7. Georg Schmorl prize of the German spine society (DWG) 2022: current treatment for inpatients with osteoporotic thoracolumbar fractures—results of the EOFTT study

Author

Ullrich, Bernhard W., Schenk, Philipp, Scheyerer, Max J., Bäumlein, Martin, Katscher, Sebastian, Schnake, Klaus J., Zimmermann, Volker, Schwarz, Falko, Schmeiser, Gregor, Scherer, Michael, Müller, Michael, Sprengel, Kai, Osterhoff, Georg, Liepold, Katja, Schramm, Simon, Baron, Christopher, Siekmann, Holger, Franck, Alexander, Isik, N., Klauke, Friederike, and Spiegl, Ulrich J. A.

Published
2023
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9. The Surgical Algorithm for the AO Spine Sacral Injury Classification System

Author

Lee, Yunsoo, Lambrechts, Mark, Narayanan, Rajkishen, Bransford, Richard, Benneker, Lorin, Schnake, Klaus, Öner, Cumhur, Canseco, Jose A., Kepler, Christopher K., Schroeder, Gregory D., Vaccaro, Alexander R., Hockley, Aaron, Zubairi, Akbar J., Barcelos, Alecio, del Arco, Alex, Weening, Alexander, Guiroy, Alfredo, Guiroy, Alfredo, Wael, Alsammak, Bhandutia, Amit, Nishanth, Ampar, Joaquim, Andrei, Joaquim, Andrei, Persin, Andrew, Gupta, Anuj, El Naga, Ashraf, El Naga, Ashraf, Ullrich, Bernhard, Saciloto, Bruno, Cheng, Christina, Bernucci, Claudio, Kleweno, Conor, Cruz, Daniel, Dizon, Dave A., Aponso, Dihan, Patronis, Dimitrios, Martinez, Elias E.J., Pola, Enrico, Gercek, Erol, Lyons, Frank, Camino-Willhuber, Gaston, Tipper, Geoffrey, Okano, Ichiro, Bances, Ignacio F., Paredes, Igor, Parampalli, Janardhana A., Matta, Javier, Subbiah, Jayakumar, Kitzen, Joep, Alves, Jorge, Montoya, Juan E.M., Lourido, Juan, Scherer, Julian, Zhang, Jun, Nitin, Kimmatkar, Margetis, Konstantinos, Rakesh, Kumar, Vineet, Kumar, Lozano, Lady C, Badalassi, Leandro, Rodríguez, Luis M.D., Kollintzas, Lykourgos, Ito, Manabu, Ganau, Mario, Estefan, Martin, Holas, Martin, Federico, Martinelli, Duarte, Matias P., Pumberger, Matthias, Scholz, Matti, Diez-Ulloa, Maximo-Alberto, Triffaux, Michel, Khattab, Mohamed, El-Sharkawi, Mohammad, Abdelhafez, Mostafa, Sathish, Muthu, Khan, Nasser, Nicola, Nicassio, Brown, Nolan, Neves, Nuno, Morillo, Olga, Alarcon, Olger, Bazán, Pedro, Loughenbury, Peter, Bancel, Philippe, Cezar, Popescu E., Rabindra, Pradhan, Moraes, Psmar, Banerjee, Purnajyoti, Lakhey, Rajesh B., Alessamdro, Ramieri, Yurac, Ratko, Vieira, Rian, Bransford, Richard, Kanna, Rishi M., Alakkad, Salah, Samy, Samer, Bigdon, Sebastian, Zylbersztejn, Sergio, Lang, Siegmund, Hashmi, Sohaib, Darwish, Stacey, Corluka, Stipe, haribabu, Subramaniam M., Karimjee, Taha, Elhewala, Tarek, Martin, Tejeda, Benzakour, Thami, Moore, Tim, Adetunji, Toluse, Torres, Valencia H., Loya, Vijay K., Hamouda, Waeel, Söyüncü, Yetkin, Silk, Zacharia, Slavisa, Zagorac, and Klezl, Zdenek

Published
2024
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10. The Surgical Algorithm for the AO Spine Sacral Injury Classification System

Author

Lee, Yunsoo, Lambrechts, Mark, Narayanan, Rajkishen, Bransford, Richard, Benneker, Lorin, Schnake, Klaus, Öner, Cumhur, Canseco, Jose A., Kepler, Christopher K., Schroeder, Gregory D., Vaccaro, Alexander R., Hockley, Aaron, Zubairi, Akbar Jaleel, Barcelos, Alecio, del Arco, Alex, Weening, Alexander, Guiroy, Alfredo, Guiroy, Alfredo, Wael, Alsammak, Bhandutia, Amit, Nishanth, Ampar, Joaquim, Andrei, Joaquim, Andrei, Persin, Andrew, Gupta, Anuj, El Naga, Ashraf, El Naga, Ashraf, Ullrich, Bernhard, Saciloto, Bruno, Cheng, Christina, Bernucci, Claudio, Kleweno, Conor, Cruz, Daniel, Dizon, Dave Anthony, Aponso, Dihan, Patronis, Dimitrios, Martinez, Elias Enmanuel Javier, Pola, Enrico, Gercek, Erol, Lyons, Frank, Camino-Willhuber, Gaston, Tipper, Geoffrey, Okano, Ichiro, Bances, Ignacio Fernández, Paredes, Igor, Parampalli, Janardhana Aithala, Matta, Javier, Subbiah, Jayakumar, Kitzen, Joep, Alves, Jorge, Montoya, Juan Esteban Muñoz, Lourido, Juan, Scherer, Julian, Zhang, Jun, Nitin, Kimmatkar, Margetis, Konstantinos, Rakesh, Kumar, Vineet, Kumar, Lozano, Lady C, Badalassi, Leandro, Rodríguez, Luis Miguel Duchén, Kollintzas, Lykourgos, Ito, Manabu, Ganau, Mario, Estefan, Martin, Holas, Martin, Federico, Martinelli, Duarte, Matias Pereira, Pumberger, Matthias, Scholz, Matti, Diez-Ulloa, Maximo-Alberto, Triffaux, Michel, Khattab, Mohamed, El-Sharkawi, Mohammad, Abdelhafez, Mostafa, Sathish, Muthu, Khan, Nasser, Nicola, Nicassio, Brown, Nolan, Neves, Nuno, Morillo, Olga, Alarcon, Olger, Bazán, Pedro, Loughenbury, Peter, Bancel, Philippe, Cezar, Popescu Eugen, Rabindra, Pradhan, Moraes, Psmar, Banerjee, Purnajyoti, Lakhey, Rajesh Bahadur, Alessamdro, Ramieri, Yurac, Ratko, Vieira, Rian, Bransford, Richard, Kanna, Rishi M, Alakkad, Salah, Samy, Samer, Bigdon, Sebastian, Zylbersztejn, Sergio, Lang, Siegmund, Hashmi, Sohaib, Darwish, Stacey, Corluka, Stipe, haribabu, Subramaniam Macherla, Karimjee, Taha, Elhewala, Tarek, Martin, Tejeda, Benzakour, Thami, Moore, Tim, Adetunji, Toluse, Torres, Valencia Heiller, Loya, Vijay Kumar, Hamouda, Waeel, Söyüncü, Yetkin, Silk, Zacharia, Slavisa, Zagorac, and Klezl, Zdenek

Published
2023
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16. Comparison of Spectral CT and MRI in Pelvic Ring Fragility Fractures: A Prospective Diagnostic Accuracy Study.

Author

Unthan, Mark, Ullrich, Bernhard W., Heinen, Camilla, Kohler, Felix C., Schenk, Philipp, Franiel, Tobias, and Bürckenmeyer, Florian

Subjects
*PELVIC fractures, *SPECTRAL sensitivity, *BONE fractures, *BONE marrow, *MAGNETIC resonance imaging
Abstract

Background/Objectives: Fragility fractures of the pelvis (FFP) are characterized by inadequate trauma to a structurally compromised bone, primarily in osteoporosis. Conventional CT studies can be inadequate in identifying FFPs. An MRI of the pelvis is considered the gold standard in diagnosing FFPs. Spectral CT or Dual-Energy CT may have comparable diagnostic accuracy. It provides additional insights into associated bone marrow edema. The aim of this prospective monocentric study is to evaluate the diagnostic accuracy of Spectral CT compared to the gold standard MRI in diagnosing FFP. Methods: Over a 2-year period, patients presenting in the emergency department with clinical suspicion of an FFP were consecutively included. They underwent Spectral CT (GE Revolution 16 cm GSI) upon admission, followed by an MRI. The gold standard for diagnosing FFP is pelvic MRI, showing sensitivity and specificity ranging from 97% to 100%. The acquired images were evaluated and classified using the osteoporotic fractures of the pelvis (OFP) classification. Results: Compared to the reference test, which was the MRI pelvis, the sensitivity of the CT pelvis was determined to be 86.8 (95% confidence interval (CI) 71.9–95.6%) with a specificity of 84.6% (95% CI: 54.6–98.1%, p = 0.453). Spectral CT could identify an additional FFP correctly, exhibiting a sensitivity of 89.5% (95% CI: 75.2–97.1%, p = 0.688), while maintaining the same specificity as the conventional CT. The inter-rater reliability assessment for Spectral CT, conducted by four independent raters, resulted in a Fleiss' Kappa value of 0.516 (95% CI: 0.450–0.582, p < 0.001). Conclusion: The sensitivity of Spectral CT in the detection of pelvic ring fragility fractures shows a slightly lower sensitivity compared to MRI. There were no statistically significant differences observed when compared to conventional CT or MRI. In conclusion, Spectral CT may be beneficial in distinguishing FFP, particularly in cases where a definitive diagnosis is uncertain. Level of Evidence: II. [ABSTRACT FROM AUTHOR]

Published
2024
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19. OF-Pelvis classification of osteoporotic sacral and pelvic ring fractures

Author

Ullrich, Bernhard W., Schnake, Klaus J., Spiegl, Ulrich J. A., Schenk, Philipp, Mendel, Thomas, Behr, Lars, Bula, Philipp, Flücht, Laura B., Franck, Alexander, Gercek, Erol, Grüninger, Sebastian, Hartung, Philipp, Jacobs, Cornelius, Katscher, Sebastian, Klauke, Friederike, Liepold, Katja, Müller, Christian W., Müller, Michael, Osterhoff, Georg, Partenheimer, Axel, Piltz, Stefan, Riehle, Marion, Sauer, Daniel, Scheyerer, Max Joseph, Schleicher, Philipp, Schmeiser, Gregor, Schmidt, René, Scholz, Matti, Siekmann, Holger, Sprengel, Kai, Stoevesandt, Dietrich, Verheyden, Akhil, and Zimmermann, Volker

Published
2021
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21. Osteoporotische Sakrumfrakturen

Author

Schnake, Klaus John, additional, Scheyerer, Max, additional, Ullrich, Bernhard Wilhelm, additional, Osterhoff, Georg, additional, Spiegl, Ulrich Josef Albert, additional, Siekmann, Holger, additional, and Lehmann, Wolfgang, additional

Published
2023
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23. Georg Schmorl prize of the German spine society (DWG) 2022: current treatment for inpatients with osteoporotic thoracolumbar fractures-results of the EOFTT study

Author

Ullrich, Bernhard W, Schenk, Philipp, Scheyerer, Max J, Bäumlein, Martin, Katscher, Sebastian, Schnake, Klaus J, Zimmermann, Volker, Schwarz, Falko, Schmeiser, Gregor, Scherer, Michael, Müller, Michael, Sprengel, Kai, Osterhoff, Georg, Liepold, Katja, Schramm, Simon, Baron, Christopher, Siekmann, Holger, Franck, Alexander, Isik, N, Klauke, Friederike, Spiegl, Ulrich J A, University of Zurich, and Ullrich, Bernhard W

Subjects
10021 Department of Trauma Surgery, 2732 Orthopedics and Sports Medicine, 610 Medicine & health, 2746 Surgery
Abstract

Osteoporotic thoracolumbar fractures are of increasing importance. To identify the optimal treatment strategy this multicentre prospective cohort study was performed.Patients suffering from osteoporotic thoracolumbar fractures were included. Excluded were tumour diseases, infections and limb fractures. Age, sex, trauma mechanism, OF classification, OF-score, treatment strategy, pain condition and mobilization were analysed.A total of 518 patients' aged 75 ± 10 (41-97) years were included in 17 centre. A total of 174 patients were treated conservatively, and 344 were treated surgically, of whom 310 (90%) received minimally invasive treatment. An increase in the OF classification was associated with an increase in both the likelihood of surgery and the surgical invasiveness.Five (3%) complications occurred during conservative treatment, and 46 (13%) occurred in the surgically treated patients. 4 surgical site infections and 2 mechanical failures requested revision surgery. At discharge pain improved significantly from a visual analogue scale score of 7.7 (surgical) and 6.0 (conservative) to a score of 4 in both groups (p 0.001). Over the course of treatment, mobility improved significantly (p = 0.001), with a significantly stronger (p = 0.007) improvement in the surgically treated patients.Fracture severity according to the OF classification is significantly correlated with higher surgery rates and higher invasiveness of surgery. The most commonly used surgical strategy was minimally invasive short-segmental hybrid stabilization followed by kyphoplasty/vertebroplasty. Despite the worse clinical conditions of the surgically treated patients both conservative and surgical treatment led to an improved pain situation and mobility during the inpatient stay to nearly the same level for both treatments.

Published
2023

24. Die OF-Pelvis-Klassifikation für osteoporotische Sakrum- und Beckenringfrakturen.

Author

Ullrich, Bernhard Wilhelm, Scheyerer, Max Joseph, Joseph Spiegl, Ulrich Albert, Mendel, Thomas, and Schnake, Klaus John

Subjects
*PELVIC fractures, *JOINT instability, *OSTEOPOROSIS, *SACRAL fractures, *COMPUTED tomography, *EDEMA
Abstract

As the population ages, the incidence of fractures of the sacrum and pelvic ring is increasing. This represents a challenge for outpatient and inpatient care facilities. The Osteoporotic Fractures Working Group of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) has developed the OF-Pelvis classification for these injuries with a view to making it reliable and easy to use. The OF-Pelvis classification divides these injuries into 5 categories. From OFP 1 to OFP 5, the injury severity and instability grade increases. Category OFP 1 corresponds to evidence of edema in the sacrum or pelvic ring without evidence of fracture on computed tomography. Category OFP 2 corresponds to a unilateral or bilateral fracture of the anterior pelvic ring on CT-scan. An OFP 3 fracture corresponds to a unilateral posterior sacral fracture with facultative fracture of the anterior pelvic ring. An OFP 4 fracture presents with a bilateral posterior sacral fracture. The highest severity is an injury which is transiliosacral or iliac and corresponds to the OFP 5 category. Three modifiers can be assigned. These indicate a higher degree of instability or further injuries. An avulsion of the transverse process of LWK 5 corresponds to modifier 1. Modifier 2 is assigned if there is dislocation of the fracture. Evidence of an edema in a location of the pelvic ring where no fracture is detectable on CT-scan corresponds to modifier 3. Initial testing of the assessment of categories and modifiers by multiple investigators showed substantial to near perfect agreement (Fleiss' kappa = 0.764-0.790 for the categories, Fleiss' kappa = 0.646-0.629 for the modifiers). The OF-Pelvis seems to be a reliable tool for the classification of osteoporotic sacral and pelvic ring fractures which can also be an aid in clinical practice for physicians not specialized in the treatment of such fractures due to its reliability and simplicity. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Der OF-Pelvis-Score.

Author

Joseph Spiegl, Ulrich Albert, Scheyerer, Max Joseph, Ullrich, Bernhard Wilhelm, and Schnake, Klaus John

Subjects
PELVIC fractures, OPERATIVE surgery, SURGICAL complications, OSTEOPOROSIS, RISK assessment, TREATMENT effectiveness, FRACTURE fixation, DECISION making in clinical medicine, BONE fractures, DISEASE risk factors, EVALUATION
Abstract

Copyright of OUP - Orthopädische und Unfallchirurgische Praxis is the property of Deutscher Aerzte-Verlag GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2024
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28. Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Body Fractures With Deformation of Both Endplates With or Without Posterior Wall Involvement (OF 4): Short-Term Results from the Prospective EOFTT Multicenter Study.

Author

Spiegl, Ulrich J A; https://orcid.org/0000-0002-5179-4192, Schenk, Philipp, Schnake, Klaus John, Ullrich, Bernhard W; https://orcid.org/0000-0001-8748-1190, Osterhoff, Georg; https://orcid.org/0000-0001-5051-0998, Scheyerer, Max J; https://orcid.org/0000-0003-1392-3990, Schmeiser, Gregor, Bäumlein, Martin, Scherer, Michael A, Müller, Michael, Sprengel, Kai; https://orcid.org/0000-0001-5921-8272, Liepold, Katja, Schramm, Simon, Baron, H-Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alex, Zimmermann, Volker, Katscher, Sebastian, et al, Spiegl, Ulrich J A; https://orcid.org/0000-0002-5179-4192, Schenk, Philipp, Schnake, Klaus John, Ullrich, Bernhard W; https://orcid.org/0000-0001-8748-1190, Osterhoff, Georg; https://orcid.org/0000-0001-5051-0998, Scheyerer, Max J; https://orcid.org/0000-0003-1392-3990, Schmeiser, Gregor, Bäumlein, Martin, Scherer, Michael A, Müller, Michael, Sprengel, Kai; https://orcid.org/0000-0001-5921-8272, Liepold, Katja, Schramm, Simon, Baron, H-Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alex, Zimmermann, Volker, Katscher, Sebastian, and et al

Abstract

STUDY DESIGN: Multicenter prospective cohort study. OBJECTIVE: To analyse therapeutical strategies applied to osteoporotic thoracolumbar OF 4 injuries, to assess related complications and clinical outcome. METHODS: A multicenter prospective cohort study (EOFTT) including 518 consecutive patients who were treated for an Osteoporotic vertebral compression fracture (OVCF). For the present study, only patients with OF 4 fractures were analysed. Outcome parameters were complications, Visual Analogue Scale, Oswestry Disability Questionnaire, Timed Up & Go test, EQ-5D 5L, and Barthel Index after a minimum follow-up of 6 weeks. RESULTS: A total of 152 (29%) patients presented with OF 4 fractures with a mean age of 76 years (range 41-97). The most common treatment was short-segment posterior stabilization (51%; hybrid stabilization in 36%). Mean follow up was 208 days (±131 days), mean ODI was 30 ± 21. Dorsoventral stabilized patients were younger compared to the other groups (P < .001) and had significant better TuG compared to hybrid stabilization (P = .049). The other clinical outcomes did not differ in the therapy strategies (VAS pain: P = 1.000, ODI: P > .602, Barthel: P > .252, EQ-5D 5L index value: P > .610, VAS-EQ-5D 5L: P = 1.000). The inpatient complication rate was 8% after conservative and 16% after surgical treatment. During follow-up period 14% of conservatively treated patients and 3% of surgical treated patients experienced neurological deficits. CONCLUSIONS: Conservative therapy of OF 4 injuries seems to be viable option in patients with only moderate symptoms. Hybrid stabilization was the dominant treatment strategy leading to promising clinical short-term results. Stand-alone cement augmentation seems to be a valid alternative in selected cases.

Published
2023

29. Clinical Evaluation of the Osteoporotic Fracture Treatment Score (OF-Score): Results of the Evaluation of the Osteoporotic Fracture Classification, Treatment Score and Therapy Recommendations (EOFTT) Study.

Author

Ullrich, Bernhard W; https://orcid.org/0000-0001-8748-1190, Schnake, Klaus John, Schenk, Philipp, Katscher, Sebastian, Bäumlein, Martin, Zimmermann, Volker, Schwarz, Falko, Schmeiser, Gregor; https://orcid.org/0000-0002-2432-8276, Scherer, Michael, Müller, Michael, Sprengel, Kai; https://orcid.org/0000-0001-5921-8272, Liepold, Katja, Schramm, Simon, Baron, Hagen-Christopher, Siekmann, Holger, Franck, Alexander, Scheyerer, Max J; https://orcid.org/0000-0003-1392-3990, Kirtas, Seyma, Spiegl, Ulrich J A, Osterhoff, Georg; https://orcid.org/0000-0001-5051-0998, et al, Ullrich, Bernhard W; https://orcid.org/0000-0001-8748-1190, Schnake, Klaus John, Schenk, Philipp, Katscher, Sebastian, Bäumlein, Martin, Zimmermann, Volker, Schwarz, Falko, Schmeiser, Gregor; https://orcid.org/0000-0002-2432-8276, Scherer, Michael, Müller, Michael, Sprengel, Kai; https://orcid.org/0000-0001-5921-8272, Liepold, Katja, Schramm, Simon, Baron, Hagen-Christopher, Siekmann, Holger, Franck, Alexander, Scheyerer, Max J; https://orcid.org/0000-0003-1392-3990, Kirtas, Seyma, Spiegl, Ulrich J A, Osterhoff, Georg; https://orcid.org/0000-0001-5051-0998, and et al

Abstract

STUDY DESIGN Multicenter prospective cohort study. OBJECTIVE The study aims to validate the recently developed OF score for treatment decisions in patients with osteoporotic vertebral compression fractures (OVCF). METHODS This is a prospective multicenter cohort study (EOFTT) in 17 spine centers. All consecutive patients with OVCF were included. The decision for conservative or surgical therapy was made by the treating physician independent of the OF score recommendation. Final decisions were compared to the recommendations given by the OF score. Outcome parameters were complications, Visual Analogue Scale, Oswestry Disability Questionnaire, Timed Up & Go test, EQ-5D 5 L, and Barthel Index. RESULTS In total, 518 patients (75.3% female, age 75 ± 10) years were included. 344 (66%) patients received surgical treatment. 71% of patients were treated following the score recommendations. For an OF score cut-off value of 6.5, the sensitivity and specificity to predict actual treatment were 60% and 68% (AUC .684, P < .001). During hospitalization overall 76 (14.7%) complications occurred. The mean follow-up rate and time were 92% and 5 ± 3.5 months, respectively. While all patients in the study cohort improved in clinical outcome parameters, the effect size was significantly less in the patients not treated in line with the OF score's recommendation. Eight (3%) patients needed revision surgery. CONCLUSIONS Patients treated according to the OF score's recommendations showed favorable short-term clinical results. Noncompliance with the score resulted in more pain and impaired functional outcome and quality of life. The OF score is a reliable and save tool to aid treatment decision in OVCF.

Published
2023

30. Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Fractures With Anterior or Posterior Tension Band Failure (OF 5): Short-Term Results From the Prospective EOFTT Multicenter Study.

Author

Osterhoff, Georg; https://orcid.org/0000-0001-5051-0998, Schenk, Philipp, Katscher, Sebastian, Schnake, Klaus John, Bäumlein, Martin, Zimmermann, Volker, Schmeiser, Gregor; https://orcid.org/0000-0002-2432-8276, Scherer, Michael A, Müller, Michael, Sprengel, Kai; https://orcid.org/0000-0001-5921-8272, Liepold, Katja, Schramm, Simon, Baron, Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alexander, Scheyerer, Max J; https://orcid.org/0000-0003-1392-3990, Spiegl, Ulrich J A, Ullrich, Bernhard W, et al, Osterhoff, Georg; https://orcid.org/0000-0001-5051-0998, Schenk, Philipp, Katscher, Sebastian, Schnake, Klaus John, Bäumlein, Martin, Zimmermann, Volker, Schmeiser, Gregor; https://orcid.org/0000-0002-2432-8276, Scherer, Michael A, Müller, Michael, Sprengel, Kai; https://orcid.org/0000-0001-5921-8272, Liepold, Katja, Schramm, Simon, Baron, Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alexander, Scheyerer, Max J; https://orcid.org/0000-0003-1392-3990, Spiegl, Ulrich J A, Ullrich, Bernhard W, and et al

Abstract

STUDY DESIGN Subgroup analysis of a multicenter prospective cohort study. OBJECTIVE To analyse surgical strategies applied to osteoporotic thoracolumbar osteoporotic fracture (OF) 5 injuries with anterior or posterior tension band failure and to assess related complications and clinical outcome. METHODS A multicenter prospective cohort study (EOFTT) was conducted at 17 spine centers including 518 consecutive patients who were treated for an osteoporotic vertebral fracture (OVF). For the present study, only patients with OF 5 fractures were analysed. Outcome parameters were complications, Visual Analogue Scale (VAS), Oswestry Disability Questionnaire (ODI), Timed Up & Go test (TUG), EQ-5D 5L, and Barthel Index. RESULTS In total, 19 patients (78 ± 7 years, 13 female) were analysed. Operative treatment consisted of long-segment posterior instrumentation in 9 cases and short-segment posterior instrumentation in 10 cases. Pedicle screws were augmented in 68 %, augmentation of the fractured vertebra was performed in 42%, and additional anterior reconstruction was done in 21 %. Two patients (11 %) received short-segment posterior instrumentation without either anterior reconstruction or cement-augmentation of the fractured vertebra. No surgical or major complications occurred, but general postoperative complications were observed in 45%. At a follow-up of mean 20 ± 10 weeks (range, 12 to 48 weeks), patients showed significant improvements in all functional outcome parameters. CONCLUSIONS In this analysis of patients with type OF 5 fractures, surgical stabilization was the treatment of choice and lead to significant short-term improvement in terms of functional outcome and quality of life despite a high general complication rate.

Published
2023

31. Georg Schmorl prize of the German spine society (DWG) 2022: current treatment for inpatients with osteoporotic thoracolumbar fractures-results of the EOFTT study

Author

Ullrich, Bernhard W; https://orcid.org/0000-0001-8748-1190, Schenk, Philipp, Scheyerer, Max J, Bäumlein, Martin, Katscher, Sebastian, Schnake, Klaus J, Zimmermann, Volker, Schwarz, Falko, Schmeiser, Gregor, Scherer, Michael, Müller, Michael, Sprengel, Kai, Osterhoff, Georg, Liepold, Katja, Schramm, Simon, Baron, Christopher, Siekmann, Holger, Franck, Alexander, Isik, N, Klauke, Friederike, Spiegl, Ulrich J A, Ullrich, Bernhard W; https://orcid.org/0000-0001-8748-1190, Schenk, Philipp, Scheyerer, Max J, Bäumlein, Martin, Katscher, Sebastian, Schnake, Klaus J, Zimmermann, Volker, Schwarz, Falko, Schmeiser, Gregor, Scherer, Michael, Müller, Michael, Sprengel, Kai, Osterhoff, Georg, Liepold, Katja, Schramm, Simon, Baron, Christopher, Siekmann, Holger, Franck, Alexander, Isik, N, Klauke, Friederike, and Spiegl, Ulrich J A

Abstract

AIM Osteoporotic thoracolumbar fractures are of increasing importance. To identify the optimal treatment strategy this multicentre prospective cohort study was performed. PURPOSE Patients suffering from osteoporotic thoracolumbar fractures were included. Excluded were tumour diseases, infections and limb fractures. Age, sex, trauma mechanism, OF classification, OF-score, treatment strategy, pain condition and mobilization were analysed. METHODS A total of 518 patients' aged 75 ± 10 (41-97) years were included in 17 centre. A total of 174 patients were treated conservatively, and 344 were treated surgically, of whom 310 (90%) received minimally invasive treatment. An increase in the OF classification was associated with an increase in both the likelihood of surgery and the surgical invasiveness. RESULTS Five (3%) complications occurred during conservative treatment, and 46 (13%) occurred in the surgically treated patients. 4 surgical site infections and 2 mechanical failures requested revision surgery. At discharge pain improved significantly from a visual analogue scale score of 7.7 (surgical) and 6.0 (conservative) to a score of 4 in both groups (p < 0.001). Over the course of treatment, mobility improved significantly (p = 0.001), with a significantly stronger (p = 0.007) improvement in the surgically treated patients. CONCLUSION Fracture severity according to the OF classification is significantly correlated with higher surgery rates and higher invasiveness of surgery. The most commonly used surgical strategy was minimally invasive short-segmental hybrid stabilization followed by kyphoplasty/vertebroplasty. Despite the worse clinical conditions of the surgically treated patients both conservative and surgical treatment led to an improved pain situation and mobility during the inpatient stay to nearly the same level for both treatments.

Published
2023

32. Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Fractures With Anterior or Posterior Tension Band Failure (OF 5): Short-Term Results From the Prospective EOFTT Multicenter Study

Author

Osterhoff, Georg, Schenk, Philipp, Katscher, Sebastian, Schnake, Klaus John, Bäumlein, Martin, Zimmermann, Volker, Schmeiser, Gregor, Scherer, Michael A, Müller, Michael, Sprengel, Kai, Liepold, Katja, Schramm, Simon, Baron, Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alexander, Scheyerer, Max J, Spiegl, Ulrich J A, Ullrich, Bernhard W, et al, and University of Zurich

Subjects
10021 Department of Trauma Surgery, 610 Medicine & health
Published
2023
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33. Clinical Evaluation of the Osteoporotic Fracture Treatment Score (OF-Score): Results of the Evaluation of the Osteoporotic Fracture Classification, Treatment Score and Therapy Recommendations (EOFTT) Study

Author

Ullrich, Bernhard W., Schnake, Klaus John, Schenk, Philipp, Katscher, Sebastian, Bäumlein, Martin, Zimmermann, Volker, Schwarz, Falko, Schmeiser, Gregor, Scherer, Michael, Müller, Michael, Sprengel, Kai, Liepold, Katja, Schramm, Simon, Baron, Hagen-Christopher, Siekmann, Holger, Franck, Alexander, Scheyerer, Max J., Kirtas, Seyma, Spiegl, Ulrich J. A., and Osterhoff, Georg

Subjects
ddc:610
Abstract

Study DesignMulticenter prospective cohort study.ObjectiveThe study aims to validate the recently developed OF score for treatment decisions in patients with osteoporotic vertebral compression fractures (OVCF).MethodsThis is a prospective multicenter cohort study (EOFTT) in 17 spine centers. All consecutive patients with OVCF were included. The decision for conservative or surgical therapy was made by the treating physician independent of the OF score recommendation. Final decisions were compared to the recommendations given by the OF score. Outcome parameters were complications, Visual Analogue Scale, Oswestry Disability Questionnaire, Timed Up & Go test, EQ-5D 5 L, and Barthel Index.ResultsIn total, 518 patients (75.3% female, age 75 ± 10) years were included. 344 (66%) patients received surgical treatment. 71% of patients were treated following the score recommendations. For an OF score cut-off value of 6.5, the sensitivity and specificity to predict actual treatment were 60% and 68% (AUC .684, P < .001). During hospitalization overall 76 (14.7%) complications occurred. The mean follow-up rate and time were 92% and 5 ± 3.5 months, respectively. While all patients in the study cohort improved in clinical outcome parameters, the effect size was significantly less in the patients not treated in line with the OF score’s recommendation. Eight (3%) patients needed revision surgery.ConclusionsPatients treated according to the OF score’s recommendations showed favorable short-term clinical results. Noncompliance with the score resulted in more pain and impaired functional outcome and quality of life. The OF score is a reliable and save tool to aid treatment decision in OVCF.

Published
2023

35. Impact of anxiety during hospitalization on the clinical outcome of patients with osteoporotic thoracolumbar vertebral fracture: a prospective multicentric study

Author

Schwarz, Falko, primary, Klee, Emma, additional, Schenk, Philipp, additional, Katscher, Sebastian, additional, Schnake, Klaus J., additional, Bäumlein, Martin, additional, Schmeiser, Gregor, additional, Scherer, Michael A., additional, Müller, Michael, additional, Sprengel, Kai, additional, Spiegl, Ulrich, additional, Osterhoff, Georg, additional, Schramm, Simon, additional, Siekmann, Holger, additional, Franck, Alexander, additional, Scheyerer, Max J., additional, and Ullrich, Bernhard W., additional

Published
2023
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37. Fibula Nail versus Locking Plate Fixation—A Biomechanical Study

Author

Kohler, Felix Christian, primary, Schenk, Philipp, additional, Nies, Theresa, additional, Hallbauer, Jakob, additional, Hofmann, Gunther Olaf, additional, Biedermann, Uta, additional, Kielstein, Heike, additional, Wildemann, Britt, additional, Ramm, Roland, additional, and Ullrich, Bernhard Wilhelm, additional

Published
2023
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38. Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Body Fractures With Deformation of Both Endplates With or Without Posterior Wall Involvement (OF 4): Short-Term Results from the Prospective EOFTT Multicenter Study

Author

Spiegl, Ulrich J A, Schenk, Philipp, Schnake, Klaus John, Ullrich, Bernhard W, Osterhoff, Georg, Scheyerer, Max J, Schmeiser, Gregor, Bäumlein, Martin, Scherer, Michael A, Müller, Michael, Sprengel, Kai, Liepold, Katja, Schramm, Simon, Baron, H-Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alex, Zimmermann, Volker, Katscher, Sebastian, et al, and University of Zurich

Subjects
10021 Department of Trauma Surgery, 610 Medicine & health
Published
2023
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39. Clinical Evaluation of the Osteoporotic Fracture Treatment Score (OF-Score): Results of the Evaluation of the Osteoporotic Fracture Classification, Treatment Score and Therapy Recommendations (EOFTT) Study

Author

Ullrich, Bernhard W, Schnake, Klaus John, Schenk, Philipp, Katscher, Sebastian, Bäumlein, Martin, Zimmermann, Volker, Schwarz, Falko, Schmeiser, Gregor, Scherer, Michael, Müller, Michael, Sprengel, Kai, Liepold, Katja, Schramm, Simon, Baron, Hagen-Christopher, Siekmann, Holger, Franck, Alexander, Scheyerer, Max J, Kirtas, Seyma, Spiegl, Ulrich J A, Osterhoff, Georg, et al, and University of Zurich

Subjects
10021 Department of Trauma Surgery, 610 Medicine & health
Published
2023
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40. Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Fractures With Anterior or Posterior Tension Band Failure (OF 5): Short-Term Results From the Prospective EOFTT Multicenter Study

Author

Osterhoff, Georg, Schenk, Philipp, Katscher, Sebastian, Schnake, Klaus John, Bäumlein, Martin, Zimmermann, Volker, Schmeiser, Gregor, Scherer, Michael A., Müller, Michael, Sprengel, Kai, Liepold, Katja, Schramm, Simon, Baron, Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alexander, Scheyerer, Max J., Spiegl, Ulrich J. A., and Ullrich, Bernhard W.

Subjects
Special Issue Articles, osteoporosis, spine, vertebral fracture, operative, OF classification, ddc
Published
2022

41. Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Body Fractures With Deformation of Both Endplates With or Without Posterior Wall Involvement (OF 4): Short-Term Results from the Prospective EOFTT Multicenter Study

Author

Spiegl, Ulrich J. A., Schenk, Philipp, Schnake, Klaus John, Ullrich, Bernhard W., Osterhoff, Georg, Scheyerer, Max J., Schmeiser, Gregor, Bäumlein, Martin, Scherer, Michael A., Müller, Michael, Sprengel, Kai, Liepold, Katja, Schramm, Simon, Baron, H.-Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alex, Zimmermann, Volker, and Katscher, Sebastian

Subjects
Special Issue Articles, osteoporosis, spine, vertebral fracture, operative, OF classification, ddc
Published
2022

42. Clinical Evaluation of the Osteoporotic Fracture Treatment Score (OF-Score): Results of the Evaluation of the Osteoporotic Fracture Classification, Treatment Score and Therapy Recommendations (EOFTT) Study

Author

Ullrich, Bernhard W., Schnake, Klaus John, Schenk, Philipp, Katscher, Sebastian, Bäumlein, Martin, Zimmermann, Volker, Schwarz, Falko, Schmeiser, Gregor, Scherer, Michael, Müller, Michael, Sprengel, Kai, Liepold, Katja, Schramm, Simon, Baron, Hagen-Christopher, Siekmann, Holger, Franck, Alexander, Scheyerer, Max J., Kirtas, Seyma, Spiegl, Ulrich J. A., and Osterhoff, Georg

Subjects
Special Issue Articles, osteoporosis, treatment, vertebral fracture, operative, OF classification, ddc
Published
2022

43. Verteilungsmuster von Knochendichte und Fettmark im Sakrum mittels quantitativer CT- und MRT-Analyse im Vergleich zwischen knochengesunden und osteoporotischen Becken

Author

Mendel, Thomas, Zänker, Katja, Schenk, Philipp, Ullrich, Bernhard W., Hofmann, Gunther O., and Klauke, Friederike

Subjects
Hounsfield, MRT, Medicine and health, Becken, Fragilitätsfrakturen, mDixon, Osteoporose, Fett, CT
Abstract

Fragestellung: Aufgrund des demografischen Wandels steigt die Prävalenz von Fragilitätsfrakturen des Beckens. Das Sakrum ist hierbei in ca. 2/3 der Fälle betroffen. Ziel dieser Studie ist es, die zonalen Differenzen der Knochendichte (KD) und des Fettmarks (FM) zwischen knochengesunden [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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44. Mittelfristiges MR-morphologisches und funktionelles Outcomes der seltenen Verletzung einer talaren Luxation (erste Ergebnisse) – Wie häufig ist die avaskuläre Talusnekrose und geht sie mit einem schlechteren Outcome einher?

Author

Brakopp, Florian Hans, Hanke, John, Kaden, Ingmar, Ullrich, Bernhard, Hofmann, Gunther, Klauke, Friederike, Schenk, Philipp, and Mendel, Thomas

Subjects
Talusnekrose, MRT, AOFAS, Medicine and health, peritalare Luxation, EFAS, VAS FA
Abstract

Fragestellung: Die talare Luxation (TL) ist eine seltene, schwerwiegende Verletzung. Eine rasche Reposition und externe Stabilisierung kann zu guten Ergebnissen führen. In der Literatur finden sich Angaben von subtalarer (46,1%) und talonavicularer Arhrose (23,1%), wobei Ergebnisse zur [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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45. Akutbehandlung stationärer Patienten mit osteoporotische Frakturen der thorakolumbalen Wirbelsäule – Ergebnisse der EOFTT-Studie

Author

Ullrich, Bernhard W., Katscher, Sebastian, Schnake, Klaus John, Bäumlein, Martin, Zimmermann, Volker, Spiegl, Ulrich, Scheyerer, Max Joseph, Schmeiser, Gregor, and Schenk, Philipp

Subjects
Medicine and health, Wirbelfraktur, Osteoporose, thorakolumbal, Therapie
Abstract

Fragestellung: Bei zunehmender Häufigkeit sind osteoporotische thorakolumbale Frakturen (OF) schon jetzt eine große Aufgabe in der Patientenversorgung.Das Spektrum der therapeutischen Optionen reicht von konservativer Therapie bis hin zur dorsoventralen Operation. Im Rahmen der Evaluation [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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46. Einfluss patientspezifischer und internistischer Faktoren auf das klinische Ergebnis nach operativer Versorgung osteoporotischer Frakturen

Author

Scheyerer, Max J., Lenz, Max, Von der Höh, Niclas, Jacobs, Cornelius, Pumberger, Matthias, Spiegl, Ulrich, Ullrich, Bernhard, and Schnake, Klaus

Subjects
osteoporotische Frakturen, ddc: 610, Medicine and health, Risikofaktoren
Abstract

Fragestellung: Osteoporotische Wirbelkörperfrakturen (OF) verdienen unsere Aufmerksamkeit, da sie zu einer Abnahme der Mobilität, einer Zunahme der Abhängigkeit und hohen Sterblichkeitsrate führen. Versagt die konservative Therapie, muss frühzeitig eine operative Intervention [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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47. Prospektive klinische Studie der diagnostischen Genauigkeit der SPECTRAL CT in der Primärdiagnostik osteoporotischer Beckenringinsuffizienzfrakturen

Author

Unthan, Mark, Kohler, Felix Christian, Heinen, Camilla, Schenk, Philipp, Franiel, Tobias, Ullrich, Bernhard W., and Bürckenmeyer, Florian

Subjects
SPECTRAL CT, Beckenringinsuffizienzfrakturen, Medicine and health, Osteoporose
Abstract

Fragestellung: Die WHO definiert Fragilitäts- oder Insuffizienzfrakturen als Verletzungen ohne adäquates Trauma aufgrund von herabgesetzter Knochenqualität. Die demographischen Veränderungen haben eine Zunahme dieser Verletzungen, insbesondere der Beckenringinsuffizienzfrakturen, [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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48. Entwicklung des OF-Pelvis Scores auf Grundlage der OF-Pelvis-Klassifikation – Retrospektive Evaluation der Therapieempfehlung anhand von 107 Patienten

Author

Spiegl, Ulrich, Ullrich, Bernhard, Scheyerer, Max Joseph, Franck, Alexander, Mendel, Thomas, Osterhoff, Georg, and Schnake, Klaus John

Subjects
Medicine and health, Klassifikation, osteoporotische Beckenringfraktur, Therapieempfehlung, OF-Pelvis Klassifikation
Abstract

Fragestellung: Ziel dieser Studie war die Entwicklung eines Scores, welcher bei der Entscheidung für oder gegen eine operative Therapie bei osteoporotischen Beckenfrakturen unterstützen soll und dessen Evaluation anhand von klinischer Fälle. Methodik: Zwischen den Jahren 2016 und [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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49. Evaluierung von OF Klassifikation, Therapie-Score und Therapieempfehlung für osteoporotische Wirbelfrakturen (EOFTT) – monozentrische Ergebnisse einer multizentrischen prospektiven Studie

Author

Martinez, Anna Lena, Schenk, Philipp, Ullrich, Bernhard, and Schnake, Klaus

Subjects
Medicine and health
Abstract

Fragestellung: Ziel der multizentrischen Studie (EOFTT) ist die prospektive Evaluation des OF-Scores und der daraus resultierenden Therapieempfehlungen für osteoporotische thorakolumbale Frakturen. Methodik: Bei der klinischen Studie handelt es sich um eine monozentrische Auswertung einer [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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50. Behandlung osteoporotischer thorakolumbaler Wirbelfrakturen mit Distraktions- oder Rotationsinstabilität (OF 5) – Ergebnisse der prospektiven multizentrischen EOFTT-Studie

Author

Osterhoff, Georg, Schenk, Philipp, Schnake, Klaus John, Scheyerer, Max Joseph, Spiegl, Ulrich, Ullrich, Bernhard W., and AG „Osteoporotische Frakturen' Der Sektion WirbelsäUle

Subjects
Wirbelsäule, OF-Klassifikation, Medicine and health, Fraktur, Osteoporose
Abstract

Fragestellung: In der neu entwickelten OF-Klassifikation für osteoporotische thorakolumbale Wirbelfrakturen (OWF) werden OF 5-Verletzungen als Verletzungen mit Distraktions- oder Rotationsinstabilität definiert und gelten daher als sehr instabil. Ziel dieser prospektiven Kohortenstudie war [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022
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