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Osteoporotische Wirbelkörperfrakturen – Von der Diagnose zur Therapie

Osteoporotic vertebral fractures—From diagnosis to treatment

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Zeitschrift für Rheumatologie Aims and scope Submit manuscript

Zusammenfassung

Ziel der vorliegenden Arbeit ist ein Überblick über aktuelle Konzepte in der Behandlung von osteoporotischen Wirbelkörperfrakturen, über Risikofaktoren, über das klinische Erscheinungsbild und das konservative und operative Management. Osteoporotische Wirbelkörperfrakturen sind ein weit verbreitetes Problem, allein in den USA sind jährlich zwischen 700.000 und 1,5 Mio. Erwachsene betroffen. Osteoporotische Wirbelkörperfrakturen können schwere körperliche Einschränkungen verursachen, einschließlich Rückenschmerzen, Funktionsstörungen und fortschreitender Kyphose der Brustwirbelsäule. Immer noch ist die Sterblichkeit nach osteoporotischen Wirbelkörperfrakturen im Vergleich zu gleichaltrigen Kontrollen erhöht. In der Versorgungsrealität über den Erdball verteilt finden sich die Verfechter der rein konservativen Therapie genauso wie die Befürworter der operativen Behandlung. Zusammenfassend kann man sagen, dass das Verständnis der Risikofaktoren, eine angemessene klinische Bewertung und Behandlungsstrategien von entscheidender Bedeutung sind. Wenn eine Operation indiziert ist, dann zeigt die Ballonkyphoplastie im Vergleich zur nichtchirurgischen Behandlung eine signifikant bessere Schmerzreduktion und eine niedrigere Sterblichkeit.

Abstract

The aim of the present work is an overview of current concepts in the treatment of osteoporotic vertebral fractures, risk factors, clinical presentation and conservative and operative management. Osteoporotic vertebral fractures are a widespread problem, affecting between 700,000 and 1.5 million adults annually in the USA alone. Osteoporotic vertebral fractures can cause severe physical impairment, including back pain, dysfunction, and progressive thoracic kyphosis. Mortality after osteoporotic vertebral fractures is still increased compared to age-matched controls. In the reality of care, advocates of purely conservative therapy as well as advocates of surgical treatment can be found all over the world. In summary, understanding the risk factors, appropriate clinical evaluation and treatment strategies are crucial. When surgery is indicated, balloon kyphoplasty shows significantly better pain reduction and lower mortality compared to nonsurgical treatment.

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Authors and Affiliations

  1. Sektion Orthopädie und Wirbelsäulenchirurgie, Klinikum Fichtelgebirge, Schillerhain 1–8, 95615, Marktredwitz, Deutschland

    Achim Benditz MHBA

  2. Klinik für Orthopädie, Unfallchirurgie und Sportmedizin, Johanna-Etienne-Krankenhaus, Neuss, Deutschland

    Jörg Jerosch

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  1. Achim Benditz MHBA
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Correspondence to Achim Benditz MHBA.

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A. Benditz und J. Jerosch geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Joachim Grifka, Bad Abbach

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Benditz, A., Jerosch, J. Osteoporotische Wirbelkörperfrakturen – Von der Diagnose zur Therapie. Z Rheumatol 82, 18–24 (2023). https://doi.org/10.1007/s00393-022-01255-9

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