Item type:Thesis, Open Access

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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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.