Untersuchung zum aktuellen Stand der Zementaugmentation in der Wirbelsäulenchirurgie in Deutschland
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Philipps-Universität Marburg
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Abstract
This study shows that cement augmentation plays an important role for the spine
surgery in Germany even after publication of the two studies from the NEJM
[Buchbinder et al. 2009; Kallmes et al. 2009]. All in all the participating operating
departments have particular expertise and experience which can be confirmed by a high
number of patients treated in one year together with the accomplishment to perform
other stabilizing operations on the spine or the potential to react to possible
complications. Regarding to the usage of different or new kyphoplasty–systems or
techniques reservation dominates. Besides kyphoplasty vertebroplasty is mainly
performed in Germany. There exists consensus in the relevance to accept osteoporosis
being a cause of many fractures of the vertebral body and to start appropriate diagnostic
and therapeutic arrangements. After the modification of the DVO–guideline in 2009
there have been little changes in procedures. Though, the evaluation yielded obvious
discrepancies concerning the period between conservative treatment and operation.
While the majority first tries conservative treatment at outpatients without memorable
cause of trauma for at least three weeks, for acute trauma patients the decision for
surgery is taken earlier. Within the first seven days a following fracture surgery is being
performed. Additionally the surgical operations treat young patients reluctantly. Most
departments set an age limit. Interventions shouldn´t take place at an age of under 50
years. The applied cement during the procedure does not need to have the feature of
being absorbable. Furthermore German surgeons do not associate the volume of cement
with pain reduction or the rate of adjacent fractures. However, cement interdigitation,
controlled cement flow, reposition of the vertebral body and creating a void before
injecting the cement are of particular importance. The comparison to a nationwide
survey from 2008 showed that there were not observed any significant differences. So
despite of being the subject of several discussions kyphoplasty is a well–established
method for treating osteoporotic vertebral fractures in German hospitals.
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Dates
Created: 2016Issued: 2016-09-29Updated: 2016-10-10
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
KyphoplastyOsteoporosis
DFG-subjects
OsteoporoseBalonkyphoplastieWirbelkörperfrakturen
DDC-Numbers
610
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Priese, Juliane: Untersuchung zum aktuellen Stand der Zementaugmentation in der Wirbelsäulenchirurgie in Deutschland. : Philipps-Universität Marburg 2016-09-29. DOI: https://doi.org/10.17192/z2016.0682.