Die perkutane Vertebroplastie (PVP) ist ein minimalinvasives Verfahren, bei welchem unter radiologischer Kontrolle Knochenzement in einen Wirbelkörper eingebracht wird. Die Technik wurde ursprünglich zur Behandlung aggressiver Wirbelkörperhämangiome eingesetzt; inzwischen stellen osteoporotische Wirbelkörperfrakturen und andere schmerzhafte Wirbelkörperprozesse - vornehmlich Metastasen - die Hauptindikationen dar. Bei der mit der PVP verwandten Kyphoplastie (KP) werden expandierbare Ballons in den Wirbelkörper eingebracht und nachfolgend die entstandene Kavität mit Zement gefüllt. Hiermit wird neben der Schmerztherapie und Stabilisierung eine Reposition und Korrektur einer lokalen Kyphose angestrebt.
Dieser Artikel erläutert die Indikationen der Verfahren, wobei der Wert einer interdisziplinären Diskussion betont wird, die es erleichtert, alternative Therapien zu erwägen und die optimale Behandlung für den Patienten zu gewährleisten. In einem zweiten Schritt werden die technischen Aspekte der Verfahren erläutert und potenzielle Komplikationen der Verfahren dargestellt. Schließlich werden die Therapieresultate der PVP und der KP unter Bezugnahme auf die bislang publizierten Arbeiten und eigene Erfahrungen dargestellt und diskutiert.
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1 * Erstveröffentlichung des Beitrags in: Radiologie up2date 2006; 3: 255 - 272
PD Dr. Stephan G. Wetzel
Abteilung für Neuroradiologie, Institut für Radiologie
Universitätsspital Basel
Petersgraben 4
4031 Basel
Schweiz
Phone: 061/265-4912
Fax: 061/265-4908
Email: swetzel@uhbs.ch
