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Aktueller Stand der Vertebroplastie und Kyphoplastie in Deutschland

Eine Untersuchung in den operativen Fachdisziplinen

Current status of vertebroplasty and kyphoplasty in Germany

An analysis of surgical disciplines

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Zusammenfassung

Ziel

Um die Verbreitung des Einsatzes von Ballonkyphoplastie (BKP) und perkutaner Vertebroplastie (PVP) in Deutschland zu untersuchen, wurden bundesweit alle operativen Fachabteilungen befragt. Die Anwender wurden nach Indikationen, Erfahrung und Expertise, der Dauer von der Diagnose bis zum Eingriff und den Komplikationen befragt.

Methoden

Insgesamt wurden an 1330 operative Fachabteilungen Fragebögen versendet.

Ergebnis

Beantwortet wurden 582 Fragebögen (43,76%); 257 führten weder BKP, noch PVP durch; 314 Fragebögen konnten ausgewertet werden. Indikationen für beide Verfahren bilden osteoporotische Wirbelkörperfrakturen, in geringerem Maße auch Hämangiome und Metastasen. Zirka 30% der Kyphoplastieanwender erachten traumatische Wirbelkörperfrakturen bei jungen Patienten als Indikation. Neben BKP und PVP führen 76% der Befragten weitere Wirbelsäuleneingriffe durch. Innerhalb der ersten 2 Wochen nach Trauma werden bereits 71% der Befragten operativ tätig. Zementextravasationen stellen die häufigste Komplikation dar.

Schlussfolgerung

Es ist gelungen, einen repräsentativen Überblick über die gängige Praxis in Deutschland zu erhalten. BKP und PVP sind weit verbreitete Verfahren und werden größtenteils von Unfallchirurgen und Orthopäden verwendet. Sowohl Anwenderzahl als auch die jährlichen Fallzahlen in den einzelnen Zentren nehmen zu.

Abstract

Objective

This study was performed to provide an overview of the current practice of balloon kyphoplasty (BKP) and percutaneous vertebroplasty (PVP) in Germany. All surgical departments were evaluated for indications, experience and expertise, and the complications.

Methods

Questionnaires were mailed to 1330 surgical departments.

Results

A total of 582 (43.76%) surveys were returned; 257 departments perform neither BKP nor PVP. Osteoporotic compression fractures and to a lesser extent hemangiomas and metastasis were treated. About 30% of the BKP users consider traumatic vertebral fractures in young patients as an indication, 76% of the respondents perform further spinal surgery, and 71% of the users operate within the first 2 weeks. For both interventions cement leakage is the most common complication.

Conclusion

Nationwide kyphoplasty and vertebroplasty are widely used by surgeons. The number of users as well as the annual number of cases in each center are increasing continuously. The partially incomplete present state of the studies must be validated by future high-quality, randomized studies.

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Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehung/en hin: A. Krüger führt Vortragstätigkeiten für die Firmen Medtronic, Soteira, Dfine und Vexim aus.

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Authors and Affiliations

  1. Klinik für Unfall-, Wiederherstellungs- und Handchirurgie, Philipps-Universität Marburg, Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße, 35033, Marburg, Deutschland

    A. Krüger, M. Bergmann, L. Oberkircher & S. Ruchholtz

  2. Diagnostische und interventionelle Radiologie, Klinikum Ernst von Bergmann, Potsdam, Deutschland

    J. Hierholzer

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  1. A. Krüger
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  2. J. Hierholzer
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  4. L. Oberkircher
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Correspondence to A. Krüger.

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Krüger, A., Hierholzer, J., Bergmann, M. et al. Aktueller Stand der Vertebroplastie und Kyphoplastie in Deutschland. Unfallchirurg 116, 813–824 (2013). https://doi.org/10.1007/s00113-012-2185-0

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