Prophylaktische Zementaugmentation zur Frakturprophylaxe und Vermeidung von Anschlusskyphosen – Sinn oder Unsinn?

Zusammenfassung

Osteoporotische Wirbelkörperfrakturen werden trotz ihrer Häufigkeit meist unterschätzt mit teils gravierenden Folgen für den Patienten. Im Sinne der Aufrechterhaltung der Lebensqualität, Mobilität und zur Vermeidung eines komplikationsträchtigen Verlaufes ist eine suffiziente Behandlung essenziell. Fester Bestandteil ist dabei heutzutage die Zementaugmentierung des betroffenen Wirbelkörpers. Allerdings zeigt sich unabhängig von der Behandlungsmodalität ein drei- bis fünffach erhöhtes Risiko für Anschlussfrakturen mit konsekutiver Kyphosierung im Segment. Ursächlich hierfür sind behandlungsbedingte Veränderungen der Biomechanik, welche mit einer Mehrbelastung der angrenzenden Grund- und Deckplatten einhergehen. Zur Reduktion der Frakturrate ist der Nutzen einer prophylaktischen Augmentierung der angrenzenden Wirbelkörper weiterhin Gegenstand der Diskussion.

Abstract

Despite their frequency, osteoporotic vertebral body fractures are usually underestimated, sometimes with serious consequences for the patient. Sufficient treatment is essential in order to maintain quality of life, mobility and to avoid a complication-prone course. An integral part is currently the cement augmentation of the affected vertebral body. However, regardless of the treatment modality, there is a three to fivefold increase in the risk of subsequent fractures with subsequent kyphosis in the segment. The causes for this are treatment-related changes in the biomechanics, which are associated with an additional load on the adjacent base and cover plates. To reduce the fracture rate, the benefit of prophylactic augmentation of the adjacent vertebral bodies is still a subject of discussion.

Schlüsselwörter

Osteoporotische Wirbelkörperfrakturen - Augmentation - Refraktur - Prophylaxe - Kyphoplastie

Keywords

osteoporotic vertebral fracture - augmentation - refracture - prophylaxis - kyphoplasty

Publikationsverlauf

Artikel online veröffentlicht:
24. Oktober 2023

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