Stability as Predictor of Mortality in Low-Energy Spinal Fractures: A Retrospective Analysis of 1356 Cases

Osteoporotic spinal fractures represent an increasingly widespread health problem in our aging society. We aimed to investigate the treatment options for low-energy spinal fractures in the el-derly and their impact on mortality, focusing on surgical stabilization using minimally invasive and open techniques. We evaluated 1356 patients over 50 years of age with compression frac-tures sustained due to low energy trauma treated at a single trauma center. We compared the mortality of patients following stable and operated/non-operated unstable compression frac-tures and the eligibility to surgery using the open and minimally invasive approach. The pa-tients received surgical or conservative care according to severity and eligibility to surgery. The mortality hazard ratio of patients who underwent screw fixation was 1.02 (P > .91), of patients who refused surgery was 1.68 (P < .001) and that of patients with anesthesiological contraindica-tion was 1.57 (P = .08), compared to conservatively treated patients with stable fractures. The dif-ference in mortality between open and minimally invasive surgeries was not significant, but the number of patients eligible for surgery with the minimally invasive procedure was significantly higher (OR: 0.25; P < .001). Spinal stability after fractures may be an important predictor of sur-vival in patients with low-impact fractures.