Zusammenfassung
Einführung: Die Vertebroplastie stellt ein relativ neues Verfahren zur Behandlung von Wirbelkörperfrakturen unterschiedlicher Genese dar. Aufgrund viel versprechender Ergebnisse steigt die Anzahl der durchgeführten Interventionen stetig an. Allerdings wird auch zunehmend über teilweise schwer wiegende Komplikationen berichtet. Eine Zusammenfassung der bisherigen Erkenntnisse scheint deshalb notwendig. Methode: Anhand einer Medline-Recherche wurden wichtige Aspekte der Vertebroplastie in den Bereichen Grundlagen, Diagnostik, Indikationen, Kontraindikationen, Technik, Ergebnisse und Komplikationen zusammengestellt. Ergebnisse: Insbesondere im Bereich der Indikationsstellung, möglicher Langzeitfolgen, sowie der „idealen” Technik sind wichtige Fragen unbeantwortet, vor allem aufgrund fehlender prospektiv, randomisierter Langzeitstudien. Schlussfolgerung: Eine endgültige Bewertung des Stellenwertes der Vertebroplastie im Bereich der osteoporotischen Frakturen gegenüber der konservativen Therapie ist aktuell nicht möglich. Für die Malignome stellt die Vertebroplastie dagegen in ausgewählten Fällen eine mögliche Therapieoption dar.
Abstract
Introduction: Vertebroplasty is a relatively new procedure for the treatment of vertebral body fractures of different origin. Due to early promising results the rate of performed procedures increases constantly. Indeed an increasing number of partially severe complications are reported. A summary of the existing findings seems therefore necessary. Methods: On the basis of a medline inquiry important aspects of vertebroplasty in the fields of basic science, diagnostics, indications, contraindications, technique, results and complications were compiled. Results: Especially for the field of indications, possible longterm effects and for the “ideal” technique open questions exist, mainly due to missing prospective, randomized long-term clinical trials. Conclusions: A final assessment of the significance of vertebroplasty for osteoporotic fractures in comparison to conservative treatment is actually not possible. In contrast vertebroplasty is a therapeutical option for malignomas in selected cases.
Schlüsselwörter
Vertebroplastie - Indikationen - Technik - Komplikationen
Key words
vertebroplasty - indications - technique - complications
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Dr. med. R. Schmidt
Orthopädische Klinik mit Querschnittgelähmtenzentrum der Universität Ulm
Oberer Eselsberg 45
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