Komplikationsmanagement im Rahmen von Zementaugmentation an der Wirbelsäule

Zusammenfassung

Die Herausforderungen durch Osteoporose-assoziierte spinale Pathologien nehmen insbesondere aufgrund der steigenden Zahl betroffener Patient:innen zu. Der Einsatz von Knochenzement ist inzwischen essenzieller Bestandteil in der Versorgung dieses herausfordernden Patientenkollektivs und wird in der Behandlung sowohl von pathologischen sowie traumatischen Frakturen als auch vereinzelt bei degenerativen Erkrankungen eingesetzt. Nichtsdestotrotz ist er bis heute mit einem hohen Komplikationsrisiko assoziiert: neben den häufig asymptomatischen, jedoch teilweise auch lebensbedrohlichen Zementleckagen führt die Zementaugmentation zu biomechanischen Veränderungen der Wirbelsäule, welche den behandelnden Operateur:innen in der präoperativen Planung und intraoperativen Umsetzung zwingend bewusst sein müssen. Gleichzeitig ist die Anwendung spezifischer Strategien zur Vermeidung dieser Komplikationen essenziell.

Abstract

Due to a rising number of affected patients, challenges in the treatment of spinal pathologies associated with osteoporosis are steadily increasing. Bone cement plays an important role in therapeutic strategies for this challenging patient cohort and is used in both pathological and traumatic fractures as well as certain degenerative pathologies of the spine. However, to date, its use is associated with a high risk for complications: besides the mostly asymptomatic but in rare cases life-threatening cement leakages, cement augmentation causes biomechanical changes which the treating surgeon needs to be aware of both in the preoperative planning and the intraoperative implementation. At the same time, applying specific strategies to avoid these complications is essential.

Schlüsselwörter

Wirbelsäulenchirurgie - Komplikationen - Zementaugmentation

Keywords

spine surgery - complications - cement augmentation

Publication History

Article published online:
24 October 2023

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