caa a22 4500 445833068 CHVBK 20180317145321.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s00586-011-1895-2 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1895-2 Risk of graft fracture after dorso-ventral thoraco-lumbar spondylodesis: is there a correlation with graft size? [Elektronische Daten] [David Kubosch, Stefan Milz, Christian Lohrmann, Karsten Schwieger, Lukas Konstantinidis, Christoph Sprecher, Norbert Südkamp, Peter Strohm] Study design: Retrospective clinical study in patients with dorso-ventral thoraco-lumbar spondylodesis. Objective: To investigate whether the ratio between graft cross sectional area and the surface area of the adjacent endplates has any effect on the midterm stability of the spondylodesis. Summary of background data: Dorso-ventral spondylodesis in the region of the thoraco-lumbar spine is one of the most frequent operations in orthopaedic surgery. Anterior stabilization with autologous iliac crest graft currently is a standard approach in many hospitals. Although numerous recommendations are given how to perform this technique, no clinical advice is available with regard to minimum graft size. Methods: Sixty-four-slice CT-scans were obtained from 82 patients 4-12 months after posterior spondylodesis with anterior implantation of iliac crest graft and stabilization with an internal fixator. The scans were analyzed using image analysis software. First, the cross sectional area of the graft was calculated and then the surface area of the adjacent endplates. The ratio between graft cross sectional area and endplate surface area was then calculated from these two values. The grafts were then evaluated in sagittal reconstruction for signs of fracture. Results: The probability for graft fracture in autologous tricortical grafts was >0.1% (p<0.001) if the graft cross sectional area exceeded 23.9% of the surface area of the adjacent endplates. Patients with lower ratio values had a higher fracture risk and below a value of 10% all grafts fractured. Conclusion: The relationship between graft cross sectional area and adjacent endplate area has an important effect on graft midterm stability in ventral spondylodesis of the thoraco-lumbar spine. In our opinion, the risk of graft fractures in dorso-ventral spondylodesis can be reduced by implantation of an appropriately sized graft without any additional procedures or instrumentation. Springer-Verlag, 2011 Graft fracture nationallicence Complication nationallicence Spinal fusion nationallicence Autologous bone graft nationallicence Kubosch David Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-University of Freiburg Medical Center, Hugstetterstr. 55, 79106, Freiburg, Germany aut Milz Stefan AO Research Institute, Davos, Switzerland aut Lohrmann Christian Department of Radiology, Albert-Ludwigs-University of Freiburg Medical Center, Freiburg, Germany aut Schwieger Karsten AO Research Institute, Davos, Switzerland aut Konstantinidis Lukas Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-University of Freiburg Medical Center, Hugstetterstr. 55, 79106, Freiburg, Germany aut Sprecher Christoph AO Research Institute, Davos, Switzerland aut Südkamp Norbert Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-University of Freiburg Medical Center, Hugstetterstr. 55, 79106, Freiburg, Germany aut Strohm Peter Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-University of Freiburg Medical Center, Hugstetterstr. 55, 79106, Freiburg, Germany aut European Spine Journal Springer-Verlag 20/10(2011-10-01), 1644-1649 0940-6719 20:10<1644 2011 20 586 https://doi.org/10.1007/s00586-011-1895-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1895-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kubosch David Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-University of Freiburg Medical Center, Hugstetterstr. 55, 79106, Freiburg, Germany aut NATIONALLICENCE 700 1- Milz Stefan AO Research Institute, Davos, Switzerland aut NATIONALLICENCE 700 1- Lohrmann Christian Department of Radiology, Albert-Ludwigs-University of Freiburg Medical Center, Freiburg, Germany aut NATIONALLICENCE 700 1- Schwieger Karsten AO Research Institute, Davos, Switzerland aut NATIONALLICENCE 700 1- Konstantinidis Lukas Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-University of Freiburg Medical Center, Hugstetterstr. 55, 79106, Freiburg, Germany aut NATIONALLICENCE 700 1- Sprecher Christoph AO Research Institute, Davos, Switzerland aut NATIONALLICENCE 700 1- Südkamp Norbert Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-University of Freiburg Medical Center, Hugstetterstr. 55, 79106, Freiburg, Germany aut NATIONALLICENCE 700 1- Strohm Peter Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-University of Freiburg Medical Center, Hugstetterstr. 55, 79106, Freiburg, Germany aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/10(2011-10-01), 1644-1649 0940-6719 20:10<1644 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer