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. 2022 Jul;142(7):1483-1490.
doi: 10.1007/s00402-021-03830-2. Epub 2021 Mar 1.

Concomitant injuries in patients with thoracic vertebral body fractures-a systematic literature review

Ulrich J Spiegl  1 , Georg Osterhoff  2 , Philipp Bula  3 , Frank Hartmann  4 , Max J Scheyerer  5 , Klaus J Schnake  6 , Bernhard W Ullrich  7
Affiliations

Concomitant injuries in patients with thoracic vertebral body fractures-a systematic literature review

Ulrich J Spiegl et al. Arch Orthop Trauma Surg. 2022 Jul.

Abstract

Purpose: The aim of this study was to give a systematic overview over the rate and location of concomitant injuries, the probability of suffering from neurological deficits, and to give evidence of the timing of surgery in severely injured patients with unstable thoracic vertebral body fractures.

Methods: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications up to November 2020 dealing with unstable fractures of the mid-thoracic spine.

Results: Altogether, 1109 articles were retrieved from the literature search. A total of 1095 articles were excluded. Thus, 16 remaining original articles were included in this systematic review depicting the topics timing of surgery in polytraumatized patients, outcome neurologic deficits, and impact of concomitant injuries. The overall level of evidence of the vast majority of studies is low.

Conclusion: The evidence of the available literature is low. The cited studies reveal that thoracic spinal fractures are associated with a high number of neurological deficits and concomitant injuries, particularly of the thoracic cage and the lung. Thereby, diagnostic algorithm should include computer tomography of the whole thoracic cage if there is any clinical sign of concomitant injuries. Patients with incomplete neurologic deficits benefit from early surgery consisting of decompression and long-segmental stabilization.

Keywords: Additional thoracic injuries; Neurologic deficit; Thoracic spine fractures; Timing of surgical stabilization.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the systematic literature review
See this image and copyright information in PMC

References

    1. Bassler D, Antes G. Lehrbuch Evidenzbasierte Medizin in Klinik und Praxis. Köln: Deutscher Ärzte-Verlag; 2000. Wie erhalte ich Antworten auf meine Fragen?
    1. Berg EE. The sternal-rib complex. A possible fourth column in thoracic spine fractures. Spine. 1993;18(13):1916–1919. doi: 10.1097/00007632-199310000-00033. - DOI - PubMed
    1. Farrugia P, Petrisor BA, Farrokhyar F, Bhandari M. Practical tips for surgical research: research questions, hypotheses and objectives. Can J Surg J Canadien de Chirurgie. 2010;53(4):278–281. - PMC - PubMed
    1. Frangen TM, Ruppert S, Muhr G, Schinkel C. The beneficial effects of early stabilization of thoracic spine fractures depend on trauma severity. J Trauma. 2010;68(5):1208–1212. doi: 10.1097/TA.0b013e3181a0e558. - DOI - PubMed
    1. Huang Z, Chen F, Huang J, Jian G, Gong H, Xu T, Wang B, Chen R, Chen X, Ye Z, Wang J, Xie D, Liu H. Treatment of middle-super thoracic fractures associated with the sternum fracture. Int J ClinExp Med. 2015;8(6):9751–9757. - PMC - PubMed

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