Osteoporotische Wirbelkörperfrakturen

Yu-Mi Ryang; Haiko Pape; Bernhard Meyer

doi:10.1055/s-0042-109629

Neurochirurgie Scan, Inhaltsverzeichnis

Neurochirurgie Scan 2016; 04(04): 303-328
DOI: 10.1055/s-0042-109629

Fortbildung

Spinale Neurochirurgie

Osteoporotische Wirbelkörperfrakturen

Autoren

Yu-Mi Ryang
Haiko Pape
Bernhard Meyer

Abstract

Zusammenfassung

Angesichts der Tatsache, dass es in Deutschland geschätzt zwischen 5 und 7 Millionen an Osteoporose erkrankter Menschen gibt, aber nur ein geringer Teil diagnostiziert und adäquat therapiert wird, besteht eine große Notwendigkeit in der Etablierung von Leitlinien und Standards, sowohl für Diagnostik und Identifizierung von Risikofaktoren als auch in der Therapie und Prophylaxe dieser „Volkskrankheit“. Durch die steigende Lebenserwartung werden die Zahl der Erkrankten und die damit verbundenen Kosten in den nächsten Jahren noch erheblich zunehmen.

Dieser Beitrag stellt zunächst Grundlagen der Erkrankung wie Epidemiologie, Definition und Risikofaktoren dar, weiter werden die etablierten Standards zu Prophylaxe, Diagnostik und konservativen Therapiemaßnahmen beschrieben, ehe detailliert auf die operativen Optionen bei osteoporotischen Wirbelkörperfrakturen eingegangen wird.

Volltext

Referenzen

Literatur
1 Kanis JA on behalf of the World Health Organization Scientific Group Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK. 2007. World Health Organization: Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical Report Series 843. Geneva: WHO; 1994
2 OʼNeill TW, Felsenberg D, Varlow J et al. The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 1996; 11: 1010-1018
3 Icks A, Haastert B, Wildner M et al. Trend of hip fracture incidence in Germany 1995–2004: a population-based study. Osteoporos Int 2008; 19: 1139-1145
4 Bleibler F, Benzinger P, Lehnert T et al. Frakturkosten im deutschen Krankenhaussektor – Welche Rolle spielt die Osteoporose?. Gesundheitswesen 2014; 76: 163-168
5 Bleibler F, Konnopka A, Benzinger P et al. The health burden and costs of incident fractures attributable to osteoporosis from 2010 to 2050 in Germany – a demographic simulation model. Osteoporos Int 2013; 24: 835-847
6 Wilson S, Sharp CA, Davie MW. Health-related quality of life in patients with osteoporosis in the absence of vertebral fracture: a systematic review. Osteoporos Int 2012; 23: 2749-2768
7 Borgstrom F, Zethraeus N, Johnell O et al. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 2006; 17: 637-650
8 Hiligsmann M, Ethgen O, Richy F et al. Utility values associated with osteoporotic fracture: a systematic review of the literature. Calcif Tissue Int 2008; 82: 288-292
9 Ismail AA, O'Neill TW, Cooper C et al. Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 1998; 8: 291-297
10 Kado DM, Duong T, Stone KL et al. Incident vertebral fractures and mortality in older women: a prospective study. Osteoporos Int 2003; 14: 589-594
11 Oleksik A, Lips P, Dawson A et al. Health-related quality of life (HRQOL) in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 2000; 15: 1384-1392
12 Zhu K, Devine A, Lewis JR et al. 'Timed up and go' test and bone mineral density measurement for fracture prediction. Arch Intern Med 2011; 171: 1655-1661
13 Lee J, Geller AI, Strasser DC. Analytical review: focus on fall screening assessments. PM R 2013; 5: 609-621
14 Schoene D, Wu SM, Mikolaizak AS et al. Discriminative ability and predictive validity of the timed up and go test in identifying older people who fall: systematic review and meta-analysis. J Am Geriatr Soc 2013; 61: 202-208
15 Link TM. Osteoporosis imaging: State of the art and advanced imaging. Radiology 2012; 263: 3-17
16 Jamal SA, Leiter RE, Bayoumi AM et al. Clinical utility of laboratory testing in women with osteoporosis. Osteoporos Int 2005; 16: 534-540
17 Tannenbaum C, Clark J, Schwartzman K et al. Yield of laboratory testing to identify secondary contributors to osteoporosis in otherwise healthy women. J Clin Endocrinol Metab 2002; 87: 4431-4437
18 Ryan CS, Petkov VI, Adler RA. Osteoporosis in men: the value of laboratory testing. Osteoporos Int 2011; 22: 1845-1853
19 Kanis JA, Borgstrom F, De Laet C et al. Assessment of fracture risk. Osteoporos Int 2005; 16: 581-589
20 Jones G, Nguyen T, Sambrook PN et al. Symptomatic fracture incidence in elderly men and women: the Dubbo Osteoporosis Epidemiology Study (DOES). Osteoporos Int 1994; 4: 277-282
21 Kanis JA, Johnell O, Oden A et al. Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 2000; 11: 669-674
22 Leslie WD, Berger C, Langsetmo L et al. Construction and validation of a simplified fracture risk assessment tool for Canadian women and men: results from the CaMos and Manitoba cohorts. Osteoporos Int 2011; 22: 1873-1883
23 Johansson H, Odén A, McCloskey EV et al. Mild morphometric vertebral fractures predict vertebral fractures but not non-vertebral fractures. Osteoporos Int 2014; 25: 235-241
24 Delmas PD, Genant HK, Crans GG et al. Severity of prevalent vertebral fractures and the risk of subsequent vertebral and nonvertebral fractures: results from the MORE trial. Bone 2003; 33: 522-532
25 Roux C, Fechtenbaum J, Kolta S et al. Mild prevalent and incident vertebral fractures are risk factors for new fractures. Osteoporos Int 2007; 18: 1617-1624
26 Pongchaiyakul C, Nguyen ND, Jones G et al. Asymptomatic vertebral deformity as a major risk factor for subsequent fractures and mortality: a long-term prospective study. J Bone Miner Res 2005; 20: 1349-1355
27 Colon-Emeric C, Kuchibhatla M, Pieper C et al. The contribution of hip fracture to risk of subsequent fractures: data from two longitudinal studies. Osteoporos Int 2003; 14: 879-883
28 Cuddihy M-T, Gabriel SE, Crowson CS et al. Forearm fractures as predictors of subsequent osteoporotic fractures. Osteoporos Int 1999; 9: 469-475
29 Kanis JA, Johansson H, Oden A et al. A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res 2004; 19: 893-899
30 Dargent-Molina P, Favier F, Grandjean H et al. Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet 1996; 348: 145-149
31 Feskanich D, Willett W, Colditz G. Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA 2002; 288: 2300-2306
32 Kanis JA, Johnell O, Oden A et al. Smoking and fracture risk: a meta-analysis. Osteoporos Int 2005; 16: 155-162
33 Johansson H, Kanis JA, Odén A et al. A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res 2014; 29: 223-233
34 Garnero P, Munoz F, Sornay-Rendu E et al. Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. The OFELY study. Bone 2007; 40: 716-722
35 Schwartz AV, Sellmeyer DE, Ensrud KE et al. Older women with diabetes have an increased risk of fracture: A prospective study. J Clin Endocrinol Metab 2001; 86: 32-38
36 Vestergaard P, Lindholm J, Joregensen JOL et al. Increased risk of osteoporotic fractures in patients with Cushing’s syndrome. Eur J Endocrinol 2002; 146: 51-56
37 Khosla S, Melton III LJ, Wermers RA et al. Primary hyperparathyroidism and the risk of fracture: a population-based study. J Bone Miner Res 1999; 14: 1700-1707
38 Shahinian VB, Kuo YF, Freeman JL et al. Risk of fracture after androgen deprivation for prostate cancer. N Engl J Med 2005; 352: 154-164
39 Coleman RE, Banks LM, Girgis SI et al. Skeletal effects of exemestane on bone-mineral density, bone biomarkers, and fracture incidence in postmenopausal women with early breast cancer participating in the Intergroup Exemestane Study (IES): a randomised controlled study. Lancet Oncol 2007; 8: 119-127
40 Van Staa TP, Leufkens HGM, Abenhaim L et al. Fracture and oral corticosteroids: relationship to daily and cumulative dose. Rheumatol 2000; 39: 1383-1389
41 Bliuc D, Nguyen ND, Milch VE et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 2009; 301: 513-521
42 Lau E, Ong K, Kurtz S et al. Mortality following the diagnosis of a vertebral compression fracture in the Medicare population. J Bone Joint Surg Am 2008; 90: 1479-1486
43 Kanis JA, McCloskey EV, Johansson H et al. Development and use of FRAX in osteoporosis. Osteoporos Int 2010; 21 (Suppl. 02) 407-413 Epub 2010 May 13
44 Howe 1 TE, Shea B, Dawson LJ et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev 2011; CD000333
45 Longo UG, Loppini M, Denaro L et al. Conservative management of patients with an osteoporotic vertebral fracture: a review of the literature. J Bone Joint Surg Br 2012; 94: 152-157
46 Müller N. Medikamentöse Schmerztherapie bei osteoporotischen Frakturen und deren Folgezuständen. Orthopäde 2010; 39: 371-379
47 Liberman UA, Weiss SR, Bröll J et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group. N Engl J Med 1995; 333: 1437-1443
48 Ensrud KE, Black DM, Palermo L et al. Treatment with alendronate prevents fractures in women at highest risk: results from the Fracture Intervention Trial. Arch Intern Med 1997; 157: 2617-2624
49 Reid DM, Adami S, Devogelaer JP et al. Risedronate increases bone density and reduces vertebral fracture risk within one year in men on corticosteroid therapy. Calcif Tissue Int 2001; 69: 242-247
50 Marcus R, Wang O, Satterwhite J et al. The skeletal response to teriparatide is largely independent of age, initial bone mineral density, and prevalent vertebral fractures in postmenopausal women with osteoporosis. J Bone Miner Res 2003; 18: 18-23
51 McClung MR, Boonen S, Törring O et al. Effect of denosumab treatment on the risk of fractures in subgroups of women with postmenopausal osteoporosis. J Bone Miner Res 2012; 27: 211-218
52 Roux C, Reginster JY, Fechtenbaum J et al. Vertebral fracture risk reduction with strontium ranelate in women with postmenopausal osteoporosis is independent of baseline risk factors. J Bone Miner Res 2006; 21: 536-542
53 Johnell O, Kanis JA, Black DM et al. Associations Between Baseline Risk Factors and Vertebral Fracture Risk in the Multiple Outcomes of Raloxifene Evaluation (MORE) Study. J Bone Miner Res 2004; 19: 764-772
54 Ringe JD, Farahmand P, Faber H et al. Sustained efficacy of risedronate in men with primary and secondary osteoporosis: results of a 2-year study. Rheumatol Int 2009; 29: 311-315
55 Saag KG, Shane E, Boonen S et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med 2007; 357: 2028-2039
56 Glüer CC, Marin F, Ringe JD et al. Comparative effects of teriparatide and risedronate in glucocorticoid-induced osteoporosis in men: 18-month results of the EuroGIOPs trial. J Bone Miner Res 2013; 28: 1355-1368
57 Smith MR, Egerdie B, Hernández Toriz N et al. Denosumab in men receiving androgen-deprivation therapy for prostate cancer. N Engl J Med 2009; 361: 745-755
58 Reginster JY. Cardiac concerns associated with strontium ranelate. Expert Opin Drug Saf 2014; 13: 1209-1213
59 Osborne V, Layton D, Perrio M et al. Incidence of venous thromboembolism in users of strontium ranelate: an analysis of data from a prescription-event monitoring study in England. Drug Saf 2010; 33: 579-591
60 Black DM, Kelly MP, Genant HK et al. Bisphosphonates and fractures of the subtrochanteric or diaphyseal femur. N Engl J Med 2010; 362: 1761-1771
61 Schilcher J, Michaëlsson K, Aspenberg P. Bisphosphonate use and atypical fractures of the femoral shaft. N Engl J Med 2011; 364: 1728-1737
62 Sedghizadeh PP, Stanley K, Caligiuri M et al. Oral bisphosphonate use and the prevalence of osteonecrosis of the jaw: an institutional inquiry. J Am Dent Assoc 2009; 140: 61-66
63 Loke YK, Jeevanantham V, Singh S. Bisphosphonates and atrial fibrillation: systematic review and meta-analysis. Drug Saf 2009; 32: 219-228
64 Grady D, Ettinger B, Moscarelli E et al. Multiple Outcomes of Raloxifene Evaluation Investigators. Safety and adverse effects associated with raloxifene: multiple outcomes of raloxifene evaluation. Obstet Gynecol 2004; 104: 837-844
65 Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006; 17: 1726-1733
66 Borgstrom F, Zethraeus N, Johnell O et al. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 2006; 17: 637-650
67 Silverman SL, Minshall ME, Shen W et al. The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum 2001; 44: 2611-2619
68 Alexandru D, So W. Evaluation and management of vertebral compression fractures. Perm J 2012; 16: 46-51
69 Staples MP, Kallmes DF, Comstock BA et al. Effectiveness of vertebroplasty using individual patient data from two randomised placebo controlled trials: meta-analysis. BMJ 2011; 343: d3952
70 Chandra RV, Yoo AJ, Hirsch JA. Vertebral augmentation: update on safety, efficacy, cost effectiveness and increased survival?. Pain Physician 2013; 16: 309-320
71 National Institute for Health and Clinical Excellence. Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures, NICE Technology Appraisal Guidance 279. London: National Institute for Health and Clinical Excellence; 2013
72 Pluijim SM, Tromp AM, Smit JH et al. Consequence of vertebral deformities in older men and women. J Bone Miner Res 2000; 15: 1564-1572
73 Harrison RA, Siminoski K, Vethanayagam D et al. Osteoporosis-related kyphosis and impairments in pulmonary function: A systematic review. J Bone Miner Res 2007; 22: 447-457
74 Miyakoshi N, Kasukawa Y, Sasaki H et al. Impact of spinal kyphosis on gastroesophageal reflux disease symptoms in patients with osteoporosis. Osteoporos Int 2009; 20: 1193-1198
75 Salaffi F, Cimmino MA, Malavolta N et al. Italian Multicentre Osteoporotic Fracture Study Group. The burden of prevalent fractures on health-related quality of life in postmenopausal women with osteoporosis: The IMOF study. J Rheumatol 2007; 34: 1551-1560
76 Kado DM, Huang MH, Karlamangla AS et al. Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study. J Am Geriatr Soc 2004; 52: 1662-1667
77 Lau E, Ong K, Kurtz S et al. Mortality following the diagnosis of a vertebral compression fracture in the Medicare population. J Bone Joint Surg Am 2008; 90: 1479-1486
78 Anselmetti GC, Bernard J, Blattert T et al. Criteria for the appropriate treatment of osteoporotic vertebral compression fractures. Pain Physician 2013; 16: E519-E530
79 DVO Leitlinie Osteoporose. Prophylaxe, Diagnostik und Therapie der Osteoporose bei Männern ab dem 60. Lebensjahr und bei postmenopausalen Frauen. 2014 http://www.dv-osteologie.org/dvo_leitlinien/osteoporose-leitlinie-2014/ (Stand: 25.08.2016)
80 Edidin AA, Ong KL, Lau E et al. Mortality risk for operated and nonoperated vertebral fracture patients in the medicare population. J Bone Miner Res 2011; 26: 1617-1626
81 Edidin AA, Ong KL, Lau E et al. Life expectancy following diagnosis of a vertebral compression fracture. Osteoporos Int 2013; 24: 451-458
82 Kashii M, Yamazaki R, Yamashita T et al. Surgical treatment for osteoporotic vertebral collapse with neurological deficits. Eur Spine J 2013; 22: 1633-1642
83 Shen M, Kim Y. Osteoporotic vertebral compression fractures: a review of current surgical management techniques. Am J Orthop (Belle Mead NJ) 2007; 36: 241-248
84 Wardlaw D, Cummings SR, Van Meirhaeghe J et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 2009; 373: 1016-1024
85 Boonen S, Van Meirhaeghe J, Bastian L et al. Balloon kyphoplasty for the treatment of acute vertebral compression fractures: 2-year results from a randomized trial. J Bone Miner Res 2011; 26: 1627-1637
86 Klazen CAH, Nohle PNM, de Vries J et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet 2009; 376: 1085-1092
87 Voormolen MHJ, Mali WPTM, Lohle PNM et al. Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fracture: The Vertos Study. AJNR Am N Neuroradiol 2007; 28: 555-560
88 Farrhoki MR, Alibai E, Maghami Z. Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. J Neurosurg Spine 2011; 14: 561-569
89 Yang EZ, Xu JG, Huang GZ et al. Percutaneous vertebroplasty versus conservative treatment in aged patients with acute osteoporotic vertebral compression fractures. Spine 2016; 41: 653-660
90 Kasperk C, Hillmeier J, Nöldge G et al. Treatment of painful vertebral fractures by kyphoplasty in patients with primary osteoporosis: a prospective nonrandomized controlled study. J Bone Miner Res 2005; 20: 604-612
91 Buchbinder R, Osborne RH, Ebeling PR et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 2009; 361: 557-567
92 Kallmes DF, Comstock BA, Heagerty PJ et al. A randomized controlled trial of vertebroplasty for osteoporotic spine fractures. N Engl J Med 2009; 361: 569-579
93 Comstock BA, Sitlani CM, Jarvik JG et al. Investigational vertebroplasty safety and efficacy trial (INVEST): patient-reported outcomes through 1 year. Radiology 2013; 269: 224-231
94 Clark W, Lyon S, Burnes J. Trials of vertebroplasty for vertebral fractures. N Engl J Med 2009; 361: 2097-2098 ; author reply 2099–2100
95 Lotz JC. Trials of vertebroplasty for vertebral fractures. N Engl J Med 2009; 361: 2098 ; author reply 2099–2100
96 Boszczyk B. Volume matters: a review of procedural details of two randomised controlled vertebroplasty trials of 2009. Eur Spine J 2010; 19: 1837-1840
97 Rousing R, Hansen KL, Anderson MO et al. Twelve-months follow-up in forty-nine patients with acute/semiacute osteoporotic vertebral fractures treated conservatively or with percutaneous vertebroplasty. Spine 2010; 35: 478-482
98 Blasco J, Martinez-Ferrer A, Macho J et al. Effect of vertebroplasty on pain relief, quality of life, and the incidence of new vertebral fractures: a 12-month randomized follow-up, controlled trial. J Bone Miner Res 2012; 27: 1159-1166
99 Vogl TJ, Pflugmacher R, Hierholzer J et al. Cement directed kyphoplasty reduces cement leakage as compared with vertebroplasty. Spine 2013; 38: 1730-1736
100 Liu JT, Li CS, Chang CS et al. Long-term follow-up study of osteoporotic vertebral compression fracture treated using balloon kyphoplasty and vertebroplasty. J Neurosurg Spine 2015; 23: 94-98
101 Rousing R, Anderson MO, Jespersen SM et al. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures. Spine 2009; 34: 1349-1354
102 Philips S, Fox N, Jacobs J et al. The direct medical costs of osteoporosis for American women aged 45 and older, 1986. Bone 1988; 9: 271-279
103 Papaioannou A, Adachi JD, Parkinson W et al. Lengthy hospitalization associated with vertebral fractures despite control for comorbid conditions. Osteporos Int 2001; 12: 870-874
104 Ong KL, Lau E, Kemner JE et al. Two-year cost comparison of vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: Are initial surgical costs misleading?. Osteporos Int 2013; 24: 1437-1445
105 Maravic M, Taupin P, Roux C. Hospital burden of vertebral fractures in France: influence of vertebroplasty. Osteporos Int 2013; 24: 2001-2006
106 Tsai YW, Hsiao FY, Wen YQ et al. Clinical outcomes of vertebroplasty or kyphoplasty for patients with vertebral compression fractures: a nationwide cohort study. J Am Med Dir Assoc 2013; 14: 41-47
107 Liu JT, Liao WJ, Tan WC et al. Balloon kyphoplasty versus vertebroplasty for treatment of osteoporotic vertebral compression fracture: a prospective, comparative, and randomized clinical trial. Osteoporos Int 2010; 21: 359-364
108 Boonen S, Wahl DA, Nauroy L et al. CSA Fracture Working Group of International Osteoporosis Foundation. Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures. Osteoporos Int 2011; 22: 2915-2934
109 Anselmetti GC, Muto M, Guglielmie G et al. Percutaneous vertebroplasty or kyphoplasty. Radiol Clin North Am 2010; 48: 641-649