Zementaugmentierte Pedikelschrauben

Zusammenfassung

Auch wenn die Augmentation von Pedikelschrauben im strukturschwachen Wirbelkörper zwischenzeitlich sicherlich zu den Standardverfahren der Wirbelsäulenchirurgie gerechnet werden darf, gibt es doch mehrere indikatorische und operationstechnische Aspekte, die berücksichtigt werden müssen. Der vorliegende Artikel möchte vor allem praxisbezogene Hinweise sowie Tipps und Tricks für die Zementaugmentation von Pedikelschrauben geben. Dabei werden wesentliche Aspekte der präoperativen Planung wie Länge des Konstrukts, Art des verwendeten Zements sowie verschiedene Schraubendesigns besprochen. Für die eigentliche OP-Durchführung werden Hinweise zu verschiedenen Zementiertechniken gegeben sowie wesentliche Aspekte der eigentlichen OP-Technik erläutert. Neben der Darstellung der eigenen Ergebnisse wird schließlich auf das Problem der Zementleckage sowie auf das potenzielle Revisionsverhalten zementaugmentierter Schrauben eingegangen.

Abstract

For situations with compromised bone quality, augmentation of pedicle screws has been established as one of the standard procedures in Europe. There are, however, several aspects that must be taken into consideration for secure and effective application of this surgical procedure. This paper aims to provide practical hints as well as some tips and tricks. Important aspects of preoperative planning are discussed such as choice of constructs with appropriate length, type of cement to be used, and different screw designs available. Different techniques of cement augmentation and essential steps of the surgical procedure are explained. Own results are presented and evaluated critically. Finally, the problem of cement leakage is discussed, and revision characteristics of cement-augmented pedicle screws are specified.

• Literatur

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