Limitierte Zementierung bei langstreckiger dorsaler Versorgung

Zusammenfassung

Die Zementaugmentation von Pedikelschrauben kann den Schraubenhalt im osteoporotischen Knochen relevant und signifikant verbessern. Die Zementaugmentation ist jedoch mit Zementaustritten und relevanten Komplikationen verbunden. Ziel muss es daher sein, die Zementaugmentation so effizient wie möglich einzusetzen. So ist es bei einer langstreckigen dorsalen Versorgung ausreichend, nur die biomechanisch am stärksten belasteten kranialen und kaudalen Pedikelschraubenpaare zu augmentieren. Dies geht in biomechanischen Tests ohne Stabilitätsverlust einher. Zudem konnte bisher keine höhere klinische Misserfolgsrate im Vergleich zur Versorgung mit Zementaugmentation aller Pedikelschrauben nachgewiesen werden. Die limitierte Zementaugmentation bietet somit eine gute Versorgungsalternative mit Reduktion der Zementmenge und damit geringerem Komplikationsrisiko bei gleicher Stabilität. Ziel dieses Übersichtsartikels ist es, die Hintergründe der limitierten Zementierung aufzuzeigen und zu beschreiben.

Abstract

Cementaugmentation of pedicle screws can significantly improve screw retention in osteoporotic bone. However, cement augmentation is associated with cement loss and significant complications. The aim must therefore be to use cement augmentation as efficiently as possible. In long-segmental posterior stabilizations, it is therefore sufficient to augment only the cranial and kaudal pedicle screw pairs that are most biomechanically stressed. This has been shown in biomechanical tests to result in no loss of stability. In addition, no higher clinical failure rates have been demonstrated in comparison to treatment with cement augmentation of all pedicle screws. Limited cement augmentation is therefore a good alternative for reducing the amount of cement and thus reducing the risk of complications while maintaining the same level of stability. The aim of this review is to present and describe the background to the technique of limited cementation.

Schlüsselwörter

Zementaugmentation - Pedikelschrauben - langstreckige posteriore Stabilisierung - Wirbelkörperfrakturen - Osteoporose

Keywords

cementaugementation - pedicle screws - vertebral body fracture - long segmental stabilization - osteoporosis

Publication History

Article published online:
24 October 2023

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