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Füllmaterialien zur Augmentation von osteoporotischen Wirbelkörperfrakturen

Filler materials for augmentation of osteoporotic vertebral fractures

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Zusammenfassung

In den letzten Jahren hat die Augmentation von Wirbelkörperkompressionsfrakturen aufgrund der guten klinischen Ergebnisse eine breite Anwendung gefunden. Die Anforderungen, die an die Füllmaterialien gestellt werden, sind vielfältig. Das Material soll gewebeverträglich sein, dem geschwächten Wirbelkörper eine ausreichende Stabilität verleihen und gleichzeitig knochenähnliche biomechanische Eigenschaften besitzen. Um die Wirbelkörperaugmentation minimal-invasiv durch perkutane Injektion durchführen zu können, muss das Material injizierbar sein und (zur kontrollierten Implantation unter Röntgendurchleuchtung) eine ausreichende Röntgenkontrastgebung besitzen. Polymethylmethacrylat (PMMA) stellt heute das am häufigsten eingesetzte Füllmaterial in der Wirbelkörperaugmentation dar. Wegen der fehlenden biologischen Eigenschaften von PMMA gewinnen jedoch die resorbierbaren Knochenersatzmaterialien, wie Calciumphosphatzement, zunehmend an Bedeutung. In der Folgenden Arbeit werden die heute zur Wirbelkörperaugmentation gängigen Knochenersatzmaterialien vorgestellt und ihre Vor- und Nachteile diskutiert.

Abstract

In the recent years augmentation of vertebral compression fracture has been widely used with satisfactory clinical results. The filler materials for use in vertebral body augmentation have to meet many requirements. They should be biocompatible, be able to stabilize the fractured vertebral body, and their biomechanical properties should approximate those of cancellous bone. Furthermore, for a minimally invasive method that involves percutaneous injection of bone substitutes, the materials should be injectable and possess good radiopacity for the fluoroscopically guided procedure. At the present, polymethylmethacrylate is the most commonly used filler material for vertebral body augmentation. Due to the lack of bioactivity of polymethylmethacrylate that remains as an inert material in the bony tissue, new resorbable filler materials like calcium phosphate cement are increasingly in the focus of interest. In the following paper, the currently used filler materials for vertebral body augmentation and their characteristics are presented.

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  1. Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburger Straße 2, 60528, Frankfurt/M., Deutschland

    M. Arabmotlagh & M. Rauschmann

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  1. M. Arabmotlagh
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  2. M. Rauschmann
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Correspondence to M. Arabmotlagh.

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Arabmotlagh, M., Rauschmann, M. Füllmaterialien zur Augmentation von osteoporotischen Wirbelkörperfrakturen. Orthopäde 39, 687–692 (2010). https://doi.org/10.1007/s00132-010-1619-z

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