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<p>Osteoporosis-related vertebral fractures are among the most frequent fracture entities in geriatric patients. They are associated with far-reaching individual and socioeconomic consequences. Adequate diagnostics and treatment are therefore essential. The osteoporotic fracture (OF) score is a&#xa0;central element in determining the right treatment. Although the majority of fractures can be healed with conservative treatment, a&#xa0;change of treatment should be considered in good time in cases of failure. Isolated cement augmentation procedures are particularly suitable for reducing pain in primarily stable osteoporotic vertebral fractures with a&#xa0;preserved framework structure (OF types 1–3) and a&#xa0;largely intact posterior edge. Dorsal cement-augmented stabilization with cementing of the fractured vertebral body leads to good results in unstable OF types 3&#xa0;and 4&#xa0;fractures. Dorsoventral procedures with cement-augmented internal fixator from the dorsal side and vertebral body replacement from the ventral side play a&#xa0;more subordinate role. Purely ventral procedures should be avoided in this patient group.</p>

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Aktuelle operative Therapiekonzepte traumatischer Frakturen der BWS und LWS bei osteoporotischer Knochensubstanz

  • 期刊论文

  • 发表日期：

    2025年1月23日

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  • Max J. Scheyerer,
  • Klaus Schnake,
  • Bernhard Ullrich,
  • Ulrich Spiegl

摘要

Osteoporosis-related vertebral fractures are among the most frequent fracture entities in geriatric patients. They are associated with far-reaching individual and socioeconomic consequences. Adequate diagnostics and treatment are therefore essential. The osteoporotic fracture (OF) score is a central element in determining the right treatment. Although the majority of fractures can be healed with conservative treatment, a change of treatment should be considered in good time in cases of failure. Isolated cement augmentation procedures are particularly suitable for reducing pain in primarily stable osteoporotic vertebral fractures with a preserved framework structure (OF types 1–3) and a largely intact posterior edge. Dorsal cement-augmented stabilization with cementing of the fractured vertebral body leads to good results in unstable OF types 3 and 4 fractures. Dorsoventral procedures with cement-augmented internal fixator from the dorsal side and vertebral body replacement from the ventral side play a more subordinate role. Purely ventral procedures should be avoided in this patient group.