Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
Department of Orthopedics and Trauma Surgery, University Hospital of Cologne, Cologne, Germany.
Eur J Trauma Emerg Surg. 2022 Jun;48(3):1639-1647. doi: 10.1007/s00068-021-01792-z. Epub 2021 Sep 29.
The aim of this systematically review is to detect differences between fractures located at the mid-thoracic spine compared to fractures of the thoracolumbar junction (TLJ) and the lumbar spine in osteoporotic vertebral body fractures.
This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications regarding osteoporotic fractures of the thoracolumbar spine with respect to the fracture location. Differences in prevalence, cause of fracture, fracture healing, and outcomes between the mid-thoracic spine and the TLJ and the lumbar spine were considered.
Altogether, 238 articles could be retrieved from the literature search. A total of 222 articles were excluded. Thus, 16 remaining original articles were included in this systematic review comprising the topics prevalence, bone mineral density and regional blood flow, biomechanics, subsequent fractures, and outcome, respectively. The overall level of evidence of the vast majority of studies was moderate to low.
Several differences between osteoporotic fractures of the mid-thoracic spine compared to the TLJ and the lumbar spine could be identified. Thereby, osteoporotic mid-thoracic fractures seem to be particularly more related to frailty without a history of traumatic injury compared to osteoporotic fractures of the TLJ and the lumbar spine. Additionally, the presence of severe mid-thoracic fractures predicts subsequent fractures of the hip. In contrast, subsequent fractures of the spine are less likely.
本系统回顾的目的是检测骨质疏松性椎体骨折中胸中段脊柱骨折与胸腰椎交界处（TLJ）和腰椎骨折之间的差异。
本综述基于在 PubMed 和 Web of Science 数据库中进行的系统检索，检索有关胸腰椎骨质疏松性骨折的文献，涉及骨折部位。考虑了胸中段脊柱和 TLJ 与腰椎之间在患病率、骨折原因、骨折愈合和结果方面的差异。
总共从文献检索中检索到 238 篇文章。共有 222 篇文章被排除。因此，16 篇剩余的原始文章被纳入本系统综述，分别涉及患病率、骨密度和区域血流、生物力学、后续骨折和结局等主题。绝大多数研究的总体证据水平为中等到低。
与 TLJ 和腰椎相比，骨质疏松性胸中段脊柱骨折有几个差异。因此，与 TLJ 和腰椎的骨质疏松性骨折相比，骨质疏松性胸中段骨折似乎与虚弱相关，而与无创伤性损伤史无关。此外，严重的胸中段骨折的存在预测髋部的后续骨折。相比之下，脊柱的后续骨折不太可能发生。
