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Orthopade ; 39(4): 417-24, 2010 Apr.
Article in German | MEDLINE | ID: mdl-20232195

ABSTRACT

Vertebral compression fractures are among the most common forms of manifestations of osteoporosis. Conservative treatment comprises adequate analgesia, osteoporosis medication and individualized physiotherapy or braces. Nevertheless, vertebral compression fractures frequently lead to persisting pain and decrease daily activity and quality of life. In these cases, kyphoplasty and vertebroplasty can be efficient treatment options. Vertebroplasty is a minimally invasive procedure, in which bone cement is filled into the vertebral body under fluoroscopic control. In most cases, this internal stabilization leads to a rapid reduction in pain. Kyphoplasty additionally aims to correct the kyphotic deformation of the broken vertebra via introducing and inflating a balloon catheter. There is broad clinical experience with both procedures. For kyphoplasty, randomized controlled trials showed significant improvements in pain and quality of life in patients undergoing kyphoplasty. However, cement leakages lead to rare but severe complications such as pulmonary embolism and nerve palsies.


Subject(s)
Fractures, Compression/surgery , Fractures, Spontaneous/surgery , Osteoporosis/surgery , Spinal Diseases/surgery , Spinal Fractures/surgery , Vertebroplasty/instrumentation , Vertebroplasty/methods , Aged, 80 and over , Bone Cements/adverse effects , Braces , Equipment Design , Evidence-Based Medicine , Extravasation of Diagnostic and Therapeutic Materials/etiology , Female , Fractures, Compression/diagnostic imaging , Fractures, Spontaneous/diagnostic imaging , Humans , Kyphosis/diagnostic imaging , Kyphosis/surgery , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/injuries , Lumbar Vertebrae/surgery , Osteoporosis/diagnostic imaging , Pain Measurement , Physical Therapy Modalities , Postoperative Complications/diagnostic imaging , Postoperative Complications/etiology , Pulmonary Embolism/etiology , Quality of Life , Randomized Controlled Trials as Topic , Recurrence , Reoperation , Spinal Diseases/diagnostic imaging , Spinal Fractures/diagnostic imaging , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/injuries , Thoracic Vertebrae/surgery , Tomography, X-Ray Computed , Treatment Outcome
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