Zusammenfassung
Die Zementaugmentation von Pedikelschrauben führt biomechanisch zu einem erhöhten Schraubenhalt im Knochen, kann jedoch auch zu klinischen Komplikationen führen. Die Vor- und Nachteile des Verfahrens werden aus unterschiedlicher klinischer Perspektive diskutiert.
Abstract
Cement augmentation of pedicle screws biomechanically increases screw purchase in the bone. However, clinical complications may occur. The pros and cons of the technique are discussed from different clinical perspectives.
Literatur
Blattert TR, Glasmacher S, Siekmann H, Schmidt C, Josten C (2009) Combined vertebral stabilization by means of cement-augmented posterior instrumentation and balloon-kyphoplasty in osteoporotic burst fractures. Eur Spine J 18:S456–S457
Hashemi A, Bednar D, Ziada S (2009) Pullout strength of pedicle screws augmented with particulate calcium phosphate: An experimental study. Spine J 9:404–410
Tolunay T, Başgül C, Demir T, Yaman ME, Arslan AK (2015) Pullout performance comparison of pedicle screws based on cement application and design parameters. Proc Inst Mech Eng H 229(11):786–793
Kolb JP, Weiser L, Kueny RA, Huber G, Rueger JM, Lehmann W (2015) Zementaugmenation an der Wirbelsäule. Was ist biomechanisch zu beachten? Orthopade 44(9):672–680
Moussazadeh N, Rubin DG, McLaughlin L, Lis E, Bilsky MH, Laufer I (2015) Short-segment percutaneous pedicle screw fixation with cement augmentation for tumor-induced spinal instability. Spine J 15(7):1609–1617
Blattert TR, Schnake KJ, Gonschorek O, Working Group Osteoporotic Fractures of the German Trauma Society (2015) Guidelines for non-surgical and surgical management of osteoporotic vertebral body fractures. Eur Spine J 24:S703
Schnake KJ, Hahn P, Franck A, Blattert T, Zimmermann V, Ullrich B, Gonschorek O, Müller M, Katscher S, Hartmann F, AG Osteoporotische Wirbelfrakturen (2013) Development of a classification system (OF-classification) and of a score for therapeutic decision making (OF-score) for osteoporotic thoracolumbar fractures. Eur Spine J 22:S2590
Bullmann V, Schmoelz W, Richter M, Grathwohl C, Schulte TL (2010) Revision of cannulated and perforated cement-augmented pedicle screws: a biomechanical study in human cadavers. Spine (Phila Pa 1986) 35(19):E932–E939
Blattert TR, Glasmacher S, Riesner HJ, Josten C (2009) Revision characteristics of cement-augmented, cannulated fenestrated pedicle screws in the osteoporotic vertebral body: a biomechanical in vitro investigation. J Neurosurg Spine 11:23–27
Koreckij T, Park D, Fischgrund J (2014) Minimally invasive spine surgery in the treatment of thoracolumbar and lumbar spine trauma. Neurosurg Focus 37:E11
Goost H, Kabir K, Wirtz D, Deborre C, Karius T, Pflugmacher R, Koch EM, Burger C, Fölsch C (2012) PMMA-Augmentation von Pedikelschrauben: Ergebnisse einer Umfrage in Deutschland. Z Orthop Unfall 150:318–323
Blattert T, Katscher S, Josten C (2011) Perkutane Techniken an der Brust- und Lendenwirbelsäule. Unfallchirurg 114:17–25
Hu M, Wu H, Chang M, Yu WK, Wang ST, Liu CL (2011) Polymethylmethacrylate augmentation of the pedicle screw: the cement distribution in the vertebral body. Eur Spine J 20:1281–1288
Janssen I, Ryang Y, Gempt J et al (2015) Risk of cement extravasation and pulmonary embolism by bone cement augmented pedicle screw fixation of the thoracolumbar spine. Eur Spine J 24:S2623
Müller J, Baldauf J, Marx S (2016) Cement leakage in pedicle screw augmentation: a prospective analysis of 98 patients and 474 augmented pedicle screws. J Neurosurg Spine 4:1–7
Quante M, Halm H (2012) Does pedicle screw augmentation with cement deteriorate complication rate and clinical results in correction spondylodesis of adult scoliosis? Eur Spine J 21:S2325
Simon M, Halm H, Quante M (2015) Complications and results of cement-augmented pedicle screws in complex corrective spondylodesis – a 2‑year follow-up of a matched-pair control study. Eur Spine J 24:S2623
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
K. Schnake weist auf folgende Beziehungen hin: Vortrags-/Kurshonorare von AOSpine und Medtronic. T. Blattert weist auf folgende Beziehungen hin: Vortrags-/Kurshonorare von Aesculap, AOSpine und Medtronic. U. Liljenqvist gibt an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.
Rights and permissions
About this article
Cite this article
Schnake, K.J., Blattert, T.R. & Liljenqvist, U. Zementaugmentation von Pedikelschrauben. Orthopäde 45, 755–759 (2016). https://doi.org/10.1007/s00132-016-3315-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00132-016-3315-0