Minimal-invasive Stabilisierung bei thorakolumbalen osteoporotischen Frakturen

Schnake KJ, Scheyerer MJ, Spiegl UJA, Perl M, Ullrich BW, Grüninger S, Osterhoff G, Katscher S, Sprengel K (2020)

Publication Type: Journal article, Review article

Publication year: 2020

Journal

Unfallchirurg Springer Verlag (Germany)

DOI: 10.1007/s00113-020-00835-1

Abstract

Background: Minimally invasive stabilization of thoracolumbar osteoporotic fractures (OF) in neurologically intact patients is well established. Various posterior and anterior surgical techniques are available. The OF classification and OF score are helpful for defining the indications and choice of operative technique. Objective: This article gives an overview of the minimally invasive stabilization techniques, typical complications and outcome. Material and methods: Selective literature search and description of surgical techniques and outcome. Results: Vertebral body augmentation alone can be indicated in painful but stable fractures of types OF 1 and OF 2 and to some extent for type OF 3. Kyphoplasty has proven to be an effective and safe procedure with a favorable clinical outcome. Unstable fractures and kyphotic deformities (types OF 3–5) should be percutaneously stabilized from posterior. The length of the pedicle screw construct depends on the extent of instability and deformity. Bone cement augmentation of the pedicle screws is indicated in severe osteoporosis but increases the complication rate. Restoration of stability of the anterior column can be achieved through additional vertebral body augmentation or rarely by anterior stabilization. Clinical and radiological short and mid-term results of the stabilization techniques are promising; however, the more invasive the surgery, the more complications occur. Conclusion: Minimally invasive stabilization techniques are safe and effective. The specific indications for the individual procedures are guided by the OF classification and the individual clinical situation of the patient.

Authors with CRIS profile

Mario Perl Lehrstuhl für Unfallchirurgie und Orthopädie

Involved external institutions

Sana Kliniken AG DE Germany (DE) Berufsgenossenschaftlichen Kliniken Bergmannstrost Halle DE Germany (DE) Universitätsklinikum Leipzig DE Germany (DE) Universitätsspital Zürich (USZ) CH Switzerland (CH) Klinikum Nürnberg DE Germany (DE) Universitätsklinikum Köln DE Germany (DE)

How to cite

APA:

Schnake, K.J., Scheyerer, M.J., Spiegl, U.J.A., Perl, M., Ullrich, B.W., Grüninger, S.,... Sprengel, K. (2020). Minimal-invasive Stabilisierung bei thorakolumbalen osteoporotischen Frakturen. Unfallchirurg. https://doi.org/10.1007/s00113-020-00835-1

MLA:

Schnake, Klaus John, et al. "Minimal-invasive Stabilisierung bei thorakolumbalen osteoporotischen Frakturen." Unfallchirurg (2020).

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