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Stellenwert der Vertebroplastie bei osteoporotisch bedingten Wirbelkörperfrakturen

  • Interventionen an der Wirbelsäule
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Zusammenfassung

Zielsetzung

Im klinischen Alltag sind osteoporotisch bedingte Kompressionsfrakturen der Wirbelkörper eine häufig diagnostizierte Erkrankung. Aktuell gewinnt die perkutane Vertebroplastie (VP) im multimodalen Behandlungskonzept osteoporotischer Wirbelkörperkompressionsfrakturen zunehmend an Bedeutung. Das Ziel dieses Artikels ist es, die aktuelle Literatur zur Vertebroplastie kritisch aufzuarbeiten und mit eigenen Ergebnissen zu vergleichen.

Material und Methoden

Für diesen Artikel wurden 7 Studien, die den postinterventionellen Verlauf von jeweils mehr als 16 Patienten beschrieben haben und seit 1997 zum Thema Vertebroplastie bei Osteoporose veröffentlicht wurden, kritisch beurteilt. Die Ergebnisse dieser Studien wurden mit eigenen Ergebnissen an 22 Patienten verglichen, die im Jahr 2002 behandelt wurden.

Ergebnisse

Unmittelbar nach Durchführung der VP wird eine sofortige Linderung der Beschwerden beschrieben. Im weiteren zeitlichen Verlauf werden eine Schmerzreduktion von bis zu 90% und eine deutliche Reduktion des Schmerzmittelbedarfs der betroffenen Patienten in der Literatur berichtet. Im Vergleich dazu konnten wir bei 17 von 22 (77%) von uns 2002 behandelten und evaluierten Patienten eine deutliche Schmerzreduktion erreichen. 18 von 22 Patienten (82%) konnten ihre Schmerzmedikation deutlich reduzieren oder vollständig beenden. Insgesamt konnte mit der perkutanen Vertebroplastie die Lebensqualität von Patienten, die schmerzhafte osteoporotische Wirbelkörperfrakturen erlitten haben, nachhaltig verbessert werden.

Diskussion

Während der letzten Jahre haben Studien zur perkutanen Vertebroplastie gezeigt, dass ein guter und schneller Behandlungserfolg erreicht werden kann und der Patient einen deutlichen Zugewinn an Lebensqualität erfährt.

Abstract

Background and purpose

Osteoporotic vertebral compression fractures are a frequently encountered clinical problem. We aimed to perform a critical, structured review of the current literature and to compare the results with our own experiences.

Material and methods

A structured review of 7 studies about vertebroplasty in osteoporotic compression fractures was performed; each study assessed at least 16 patients and was published in English since 1997. The results were compared to our own experience in 22 patients treated in 2002.

Results

Over the past decade, vertebroplasty has increasingly been performed for the treatment of painful osteoporotic vertebral body compression fractures. In good correlation with our own results, all authors reported a significant improvement of pain immediately after treatment and a reduction of pain of up to 90% within 24 h after vertebroplasty. Furthermore, a significant reduction in the use of analgetics and a substantial improvement of functional status has been described in recent studies. In our own evaluation, we were also able to demonstrate a significant improvement of pain after vertebroplasty in 17 of 22 (77%) of our patients. 18 of 22 (82%) patients were able to diminish or even discontinue their analgesic medication.

Discussion

Reported results for vertebroplasty have demonstrated a rapid improvement in pain and physical functioning in patients with osteoporotic vertebral compression fractures. Percutaneous vertebroplasty has proven to provide a valuable treatment option for osteoporotic vertebral compression fractures.

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Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum der Universität München-Großhadern

    R. T. Hoffmann, T. F. Jakobs, B. B. Ertl-Wagner, A. Wallnöfer, M. F. Reiser & T. K. Helmberger

  2. Institut für Klinische Radiologie, Klinikum der Universität München-Großhadern, Marchioninistr. 15, 81377 , München

    R. T. Hoffmann

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  1. R. T. Hoffmann
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Correspondence to R. T. Hoffmann.

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Hoffmann, R.T., Jakobs, T.F., Ertl-Wagner, B.B. et al. Stellenwert der Vertebroplastie bei osteoporotisch bedingten Wirbelkörperfrakturen. Radiologe 43, 729–734 (2003). https://doi.org/10.1007/s00117-003-0951-2

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