{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T07:40:16Z","timestamp":1782286816214,"version":"3.54.5"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T00:00:00Z","timestamp":1634256000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T00:00:00Z","timestamp":1634256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Leipzig"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Calcif Tissue Int"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To assess the potential influence of multifidus atrophy and fatty degeneration on the incidence of adjacent vertebral compression fractures within one year after the index fracture. In a retrospective cohort study, patients who underwent surgery for an OVCF were identified and baseline characteristics, fracture patterns and the occurrence of secondary adjacent fractures within one year were obtained by chart review. Multifidus muscle atrophy and fatty degeneration were determined on preoperative MRI or CT scans. In this analysis of 191 patients (mean age 77\u00a0years, SD 8, 116 female), OF type 3 was the most common type of OVCF (49.2%). Symptomatic adjacent OVCFs within one year after index fracture were observed in 23\/191 patients (12%) at mean 12, SD 12\u00a0weeks (range 1\u201342\u00a0weeks) postoperatively. The mean multifidus muscle area was 264, SD 53\u00a0mm<jats:sup>2<\/jats:sup> in patients with an adjacent vertebral fracture and 271, SD 92\u00a0mm<jats:sup>2<\/jats:sup> in patients without a secondary fracture (p\u2009=\u20090.755). Mean multifidus fatty infiltration was graded Goutallier 2.2, SD 0.6 in patients with an adjacent fracture and Goutallier 2.2, SD 0.7 in patients without an adjacent fracture (p\u2009=\u20090.694). Pre-existing medication with corticosteroids was associated with the occurrence of an adjacent fracture (p\u2009=\u20090.006). Multifidus area and multifidus fatty infiltration had no significant effect on the occurrence of adjacent vertebral fractures within one year after the index fracture. Patients with a pre-existing medication with corticosteroids were more likely to sustain an adjacent fracture.<\/jats:p>","DOI":"10.1007\/s00223-021-00925-1","type":"journal-article","created":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T19:41:01Z","timestamp":1634326861000},"page":"421-427","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Impact of Multifidus Muscle Atrophy on the Occurrence of Secondary Symptomatic Adjacent Osteoporotic Vertebral Compression Fractures"],"prefix":"10.1007","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5051-0998","authenticated-orcid":false,"given":"Georg","family":"Osterhoff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garnik","family":"Asatryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich J. A.","family":"Spiegl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Pfeifle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Sven","family":"Jarvers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph-E.","family":"Heyde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,15]]},"reference":[{"issue":"8","key":"925_CR1","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1007\/s00198-008-0816-7","volume":"20","author":"T Matsumoto","year":"2009","unstructured":"Matsumoto T, Hagino H, Shiraki M, Fukunaga M, Nakano T, Takaoka K, Morii H, Ohashi Y, Nakamura T (2009) Effect of daily oral minodronate on vertebral fractures in Japanese postmenopausal women with established osteoporosis: a randomized placebo-controlled double-blind study. Osteoporos Int 20(8):1429\u20131437. https:\/\/doi.org\/10.1007\/s00198-008-0816-7","journal-title":"Osteoporos Int"},{"issue":"5","key":"925_CR2","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1007\/s00586-019-05957-8","volume":"28","author":"UJ Spiegl","year":"2019","unstructured":"Spiegl UJ, Anem\u00fcller C, Jarvers J-S, von der H\u00f6h N, Josten C, Heyde C-E (2019) Hybrid stabilization of unstable osteoporotic thoracolumbar vertebral body fractures: clinical and radiological outcome after a mean of 4 years. Eur Spine J 28(5):1130\u20131137. https:\/\/doi.org\/10.1007\/s00586-019-05957-8","journal-title":"Eur Spine J"},{"issue":"5","key":"925_CR3","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1007\/s00586-011-2099-5","volume":"21","author":"Y-J Rho","year":"2012","unstructured":"Rho Y-J, Choe WJ, Chun YI (2012) Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J 21(5):905\u2013911. https:\/\/doi.org\/10.1007\/s00586-011-2099-5","journal-title":"Eur Spine J"},{"issue":"1","key":"925_CR4","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1007\/s11657-018-0489-6","volume":"13","author":"H Teuber","year":"2018","unstructured":"Teuber H, Tiziani S, Halvachizadeh S, Frey D, Sprengel K, Pape H-C, Osterhoff G (2018) Single-level vertebral kyphoplasty is not associated with an increased risk of symptomatic secondary adjacent osteoporotic vertebral compression fractures: a matched case-control analysis. Arch Osteoporos 13(1):82. https:\/\/doi.org\/10.1007\/s11657-018-0489-6","journal-title":"Arch Osteoporos"},{"issue":"6","key":"925_CR5","first-page":"565","volume":"18","author":"L Ning","year":"2015","unstructured":"Ning L, Wan S, Liu C, Huang Z, Cai H, Fan S (2015) New levels of vertebral compression fractures after percutaneous kyphoplasty: retrospective analysis of styles and risk factors. Pain Physician 18(6):565\u2013572","journal-title":"Pain Physician"},{"issue":"6","key":"925_CR6","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1007\/s00776-014-0610-7","volume":"19","author":"Y-T Wang","year":"2014","unstructured":"Wang Y-T, Wu X-T, Chen H, Wang C, Mao Z-B (2014) Adjacent-level symptomatic fracture after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: a retrospective analysis. J Orthop Sci 19(6):868\u2013876. https:\/\/doi.org\/10.1007\/s00776-014-0610-7","journal-title":"J Orthop Sci"},{"issue":"11","key":"925_CR7","doi-asserted-by":"publisher","first-page":"3424","DOI":"10.1007\/s00586-015-3805-5","volume":"25","author":"T Hida","year":"2016","unstructured":"Hida T, Shimokata H, Sakai Y, Ito S, Matsui Y, Takemura M, Kasai T, Ishiguro N, Harada A (2016) Sarcopenia and sarcopenic leg as potential risk factors for acute osteoporotic vertebral fracture among older women. Eur Spine J 25(11):3424\u20133431. https:\/\/doi.org\/10.1007\/s00586-015-3805-5","journal-title":"Eur Spine J"},{"key":"925_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2021.07.020","author":"I Jeon","year":"2021","unstructured":"Jeon I, Kim SW, Yu D (2021) Paraspinal muscle fatty degeneration as a predictor of progressive vertebral collapse in osteoporotic vertebral compression fractures. Spine J. https:\/\/doi.org\/10.1016\/j.spinee.2021.07.020","journal-title":"Spine J"},{"issue":"2","key":"925_CR9","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1007\/s00774-020-01131-z","volume":"39","author":"S-B Zhang","year":"2021","unstructured":"Zhang S-B, Chen H, Xu H-W, Yi Y-Y, Wang S-J, Wu D-S (2021) Association between handgrip strength and subsequent vertebral-fracture risk following percutaneous vertebral augmentation. J Bone Miner Metab 39(2):186\u2013192. https:\/\/doi.org\/10.1007\/s00774-020-01131-z","journal-title":"J Bone Miner Metab"},{"issue":"7","key":"925_CR10","doi-asserted-by":"publisher","first-page":"577","DOI":"10.2106\/JBJS.L.00024","volume":"95","author":"CM Werner","year":"2013","unstructured":"Werner CM, Osterhoff G, Schlickeiser J, Jenni R, Wanner GA, Ossendorf C, Simmen HP (2013) Vertebral body stenting versus kyphoplasty for the treatment of osteoporotic vertebral compression fractures: a randomized trial. J Bone Joint Surg 95(7):577\u2013584. https:\/\/doi.org\/10.2106\/JBJS.L.00024","journal-title":"J Bone Joint Surg"},{"issue":"23","key":"925_CR11","doi-asserted-by":"publisher","first-page":"2028","DOI":"10.1097\/BRS.0b013e3182a8a381","volume":"38","author":"AR Vaccaro","year":"2013","unstructured":"Vaccaro AR, Oner C, Kepler CK, Dvorak M, Schnake K, Bellabarba C, Reinhold M, Aarabi B, Kandziora F, Chapman J, Shanmuganathan R, Fehlings M, Vialle L (2013) AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine 38(23):2028\u20132037. https:\/\/doi.org\/10.1097\/BRS.0b013e3182a8a381","journal-title":"Spine"},{"issue":"2","key":"925_CR12","doi-asserted-by":"publisher","first-page":"46S","DOI":"10.1177\/2192568217717972","volume":"8","author":"KJ Schnake","year":"2018","unstructured":"Schnake KJ, Blattert TR, Hahn P, Franck A, Hartmann F, Ullrich B, Verheyden A, M\u00f6rk S, Zimmermann V, Gonschorek O, M\u00fcller M, Katscher S, Saman AE, Pajenda G, Morrison R, Schinkel C, Piltz S, Partenheimer A, M\u00fcller CW, Gercek E, Scherer M, Bouzraki N, Kandziora F (2018) Classification of osteoporotic thoracolumbar spine fractures: recommendations of the spine section of the german society for orthopaedics and trauma (DGOU). Global Spine J 8(2):46S-49S. https:\/\/doi.org\/10.1177\/2192568217717972","journal-title":"Global Spine J"},{"issue":"7","key":"925_CR13","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1038\/nmeth.2089","volume":"9","author":"CA Schneider","year":"2012","unstructured":"Schneider CA, Rasband WS, Eliceiri KW (2012) NIH Image to ImageJ: 25 years of image analysis. Nat Methods 9(7):671\u2013675. https:\/\/doi.org\/10.1038\/nmeth.2089","journal-title":"Nat Methods"},{"issue":"1","key":"925_CR14","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s00256-013-1748-7","volume":"43","author":"M Farshad","year":"2014","unstructured":"Farshad M, Gerber C, Farshad-Amacker NA, Dietrich TJ, Laufer-Molnar V, Min K (2014) Asymmetry of the multifidus muscle in lumbar radicular nerve compression. Skeletal Radiol 43(1):49\u201353. https:\/\/doi.org\/10.1007\/s00256-013-1748-7","journal-title":"Skeletal Radiol"},{"key":"925_CR15","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1097\/00003086-199407000-00014","volume":"304","author":"D Goutallier","year":"1994","unstructured":"Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 304:78\u201383","journal-title":"Clin Orthop Relat Res"},{"issue":"8","key":"925_CR16","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1007\/s00113-019-0658-0","volume":"122","author":"MJ Scheyerer","year":"2019","unstructured":"Scheyerer MJ, Ullrich B, Osterhoff G, Spiegl UA, Schnake KJ (2019) \u201eHounsfield units\u201c als Ma\u00df f\u00fcr die Knochendichte\u2014Anwendungsm\u00f6glichkeiten in der Wirbels\u00e4ulenchirurgie (Hounsfield units as a measure of bone density-applications in spine surgery). Unfallchirurg 122(8):654\u2013661. https:\/\/doi.org\/10.1007\/s00113-019-0658-0","journal-title":"Unfallchirurg"},{"key":"925_CR17","unstructured":"Soper DS (2021) A-priori sample size calculator for multiple regression. https:\/\/www.danielsoper.com\/statcalc. Accessed 16 Sept 2021"},{"issue":"5","key":"925_CR18","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1007\/s00198-008-0745-5","volume":"20","author":"AS Mudano","year":"2009","unstructured":"Mudano AS, Bian J, Cope JU, Curtis JR, Gross TP, Allison JJ, Kim Y, Briggs D, Melton ME, Xi J, Saag KG (2009) Vertebroplasty and kyphoplasty are associated with an increased risk of secondary vertebral compression fractures: a population-based cohort study. Osteoporos Int 20(5):819\u2013826. https:\/\/doi.org\/10.1007\/s00198-008-0745-5","journal-title":"Osteoporos Int"},{"issue":"9668","key":"925_CR19","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1016\/S0140-6736(09)60010-6","volume":"373","author":"D Wardlaw","year":"2009","unstructured":"Wardlaw D, Cummings SR, van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, Eastell R, Shabe P, Talmadge K, Boonen S (2009) Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 373(9668):1016\u20131024. https:\/\/doi.org\/10.1016\/S0140-6736(09)60010-6","journal-title":"Lancet"},{"issue":"1","key":"925_CR20","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s00402-013-1886-3","volume":"134","author":"X Yi","year":"2014","unstructured":"Yi X, Lu H, Tian F, Wang Y, Li C, Liu H, Liu X, Li H (2014) Recompression in new levels after percutaneous vertebroplasty and kyphoplasty compared with conservative treatment. Arch Orthop Trauma Surg 134(1):21\u201330. https:\/\/doi.org\/10.1007\/s00402-013-1886-3","journal-title":"Arch Orthop Trauma Surg"},{"issue":"1","key":"925_CR21","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1038\/s41598-017-10899-6","volume":"7","author":"A Garc\u00eda-Sempere","year":"2017","unstructured":"Garc\u00eda-Sempere A, Hurtado I, Sanf\u00e9lix-Genov\u00e9s J, Rodr\u00edguez-Bernal CL, Gil Orozco R, Peir\u00f3 S, Sanf\u00e9lix-Gimeno G (2017) Primary and secondary non-adherence to osteoporotic medications after hip fracture in Spain: the PREV2FO population-based retrospective cohort study. Sci Rep 7(1):447. https:\/\/doi.org\/10.1038\/s41598-017-10899-6","journal-title":"Sci Rep"},{"issue":"8","key":"925_CR22","first-page":"E1167","volume":"19","author":"CP Deibert","year":"2016","unstructured":"Deibert CP, Gandhoke GS, Paschel EE, Gerszten PC (2016) A Longitudinal cohort investigation of the development of symptomatic adjacent level compression fractures following balloon-assisted kyphoplasty in a series of 726 patients. Pain Physician 19(8):E1167\u2013E1172","journal-title":"Pain Physician"},{"issue":"9746","key":"925_CR23","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1016\/S0140-6736(10)60954-3","volume":"376","author":"CAH Klazen","year":"2010","unstructured":"Klazen CAH, Lohle PNM, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, Venmans A, van Rooij WJJ, Schoemaker MC, Juttmann JR, Lo TH, Verhaar HJJ, van der Graaf Y, van Everdingen KJ, Muller AF, Elgersma OEH, Halkema DR, Fransen H, Janssens X, Buskens E, Mali WPTM (2010) Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (vertos II): an open-label randomised trial. The Lancet 376(9746):1085\u20131092. https:\/\/doi.org\/10.1016\/S0140-6736(10)60954-3","journal-title":"The Lancet"},{"issue":"4","key":"925_CR24","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/s0002-9343(02)01524-3","volume":"114","author":"TH Diamond","year":"2003","unstructured":"Diamond TH, Champion B, Clark WA (2003) Management of acute osteoporotic vertebral fractures: a nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy. Am J Med 114(4):257\u2013265. https:\/\/doi.org\/10.1016\/s0002-9343(02)01524-3","journal-title":"Am J Med"},{"issue":"11","key":"925_CR25","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1111\/j.1526-4637.2010.00959.x","volume":"11","author":"H-K Wang","year":"2010","unstructured":"Wang H-K, Lu K, Liang C-L, Weng H-C, Wang K-W, Tsai Y-D, Hsieh C-H, Liliang P-C (2010) Comparing clinical outcomes following percutaneous vertebroplasty with conservative therapy for acute osteoporotic vertebral compression fractures. Pain Med 11(11):1659\u20131665. https:\/\/doi.org\/10.1111\/j.1526-4637.2010.00959.x","journal-title":"Pain Med"},{"key":"925_CR26","doi-asserted-by":"publisher","first-page":"E13","DOI":"10.36076\/ppj.2017.1.E13","volume":"20","author":"H Zhang","year":"2017","unstructured":"Zhang H, Xu C, Zhang T, Gao Z (2017) Does percutaneous vertebroplasty or balloon kyphoplasty for osteoporotic vertebral compression fractures increase the incidence of new vertebral fractures? A meta-analysis. Pain Physician 20:E13\u2013E28","journal-title":"Pain Physician"},{"key":"925_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2020.108867","volume":"125","author":"N Sollmann","year":"2020","unstructured":"Sollmann N, Franz D, Burian E, L\u00f6ffler MT, Probst M, Gersing A, Schwaiger B, Pfeiffer D, Kirschke JS, Baum T, Riederer I (2020) Assessment of paraspinal muscle characteristics, lumbar BMD, and their associations in routine multi-detector CT of patients with and without osteoporotic vertebral fractures. Eur J Radiol 125:108867. https:\/\/doi.org\/10.1016\/j.ejrad.2020.108867","journal-title":"Eur J Radiol"},{"issue":"1","key":"925_CR28","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1186\/s12891-018-2064-0","volume":"19","author":"M Katsu","year":"2018","unstructured":"Katsu M, Ohba T, Ebata S, Haro H (2018) Comparative study of the paraspinal muscles after OVF between the insufficient union and sufficient union using MRI. BMC Musculoskelet Disord 19(1):878. https:\/\/doi.org\/10.1186\/s12891-018-2064-0","journal-title":"BMC Musculoskelet Disord"},{"issue":"6","key":"925_CR29","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1007\/s00198-020-05338-8","volume":"31","author":"S Takahashi","year":"2020","unstructured":"Takahashi S, Hoshino M, Takayama K, Sasaoka R, Tsujio T, Yasuda H, Kanematsu F, Kono H, Toyoda H, Ohyama S, Hori Y, Nakamura H (2020) The natural course of the paravertebral muscles after the onset of osteoporotic vertebral fracture. Osteoporos Int 31(6):1089\u20131095. https:\/\/doi.org\/10.1007\/s00198-020-05338-8","journal-title":"Osteoporos Int"},{"key":"925_CR30","doi-asserted-by":"publisher","first-page":"2562957","DOI":"10.1155\/2017\/2562957","volume":"2017","author":"L Kalichman","year":"2017","unstructured":"Kalichman L, Carmeli E, Been E (2017) The association between imaging parameters of the paraspinal muscles, spinal degeneration, and low back pain. Biomed Res Int 2017:2562957. https:\/\/doi.org\/10.1155\/2017\/2562957","journal-title":"Biomed Res Int"},{"issue":"6","key":"925_CR31","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.3233\/BMR-150506","volume":"30","author":"Q Li","year":"2017","unstructured":"Li Q, Sun J, Cui X, Jiang Z, Li T (2017) Analysis of correlation between degeneration of lower lumbar paraspinal muscles and spinopelvic alignment in patients with osteoporotic vertebral compression fracture. BMR 30(6):1209\u20131214. https:\/\/doi.org\/10.3233\/BMR-150506","journal-title":"BMR"},{"issue":"8","key":"925_CR32","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1007\/s00586-006-0276-8","volume":"16","author":"AM Briggs","year":"2007","unstructured":"Briggs AM, Greig AM, Bennell KL, Hodges PW (2007) Paraspinal muscle control in people with osteoporotic vertebral fracture. Eur Spine J 16(8):1137\u20131144. https:\/\/doi.org\/10.1007\/s00586-006-0276-8","journal-title":"Eur Spine J"},{"issue":"24","key":"925_CR33","doi-asserted-by":"publisher","first-page":"2959","DOI":"10.1097\/00007632-199712150-00020","volume":"22","author":"PB O'Sullivan","year":"1997","unstructured":"O\u2019Sullivan PB, Phyty GDM, Twomey LT, Allison GT (1997) Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine 22(24):2959\u20132967. https:\/\/doi.org\/10.1097\/00007632-199712150-00020","journal-title":"Spine"}],"container-title":["Calcified Tissue International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00223-021-00925-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00223-021-00925-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00223-021-00925-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T14:05:37Z","timestamp":1647439537000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00223-021-00925-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,15]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["925"],"URL":"https:\/\/doi.org\/10.1007\/s00223-021-00925-1","relation":{},"ISSN":["1432-0827"],"issn-type":[{"value":"1432-0827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,15]]},"assertion":[{"value":"30 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Georg Osterhoff, Garnik Asatryan, Ulrich J. A. Spiegl, Christian Pfeifle, Jan-Sven Jarvers, and Christoph-E. Heyde declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the local institutional ethics committee (reference 316\/19-ek). The study was conducted in accordance with all local regulations and followed the principles of the Helsinki declaration.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"Informed consent was not obtained due to the retrospective nature of the study in accordance with \u00a734 of the Saxon Hospital Act. Patients who earlier had expressed objection to the use of their data for research purposes were excluded.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}}]}}