Wirbelkörperfrakturen und Osteopenie: Augmentieren oder langstreckig? Vertebral body fractures and osteopenia: augmentation or lengthening?

Publikationstyp
Review Article
Publikationsdatum
2017-06-01
Sprache
German
Author
Weiser, Lukas 
Viezens, Lennart 
Huber, Gerd 
Lehmann, Wolfgang 
Institut
Biomechanik M-3 
TORE-URI
http://hdl.handle.net/11420/3915
Enthalten in
Trauma und Berufskrankheit 
Start Page
80
End Page
85
Citation
Trauma und Berufskrankheit 2 (19): 80-85 (2017-06-01)
Publisher DOI
10.1007/s10039-017-0262-x
Scopus ID
2-s2.0-85019176881
Background: Vertebral fractures are the most common manifestation of osteoporosis. If an interventional therapy is needed besides kyphoplasty, stabilisation with pedicle screws is commonly accepted. Loosening of pedicle screws is one of the major complications in posterior spinal stabilisation, especially in the osteoporotic spine. Augmentation of pedicle screws with cement or lengthening of the instrumentation are widely used to improve stability in these patients. Materials and methods: A biomechanical test was performed. Twelve osteoporotic human spines (Th11–L3) were randomised by bone mineral density into two groups. A short instrumentation was compared to an extended instrumentation using a fatigue testing setup with a cranial–caudal sinusoidal, cyclic (1.0 Hz) load with stepwise increasing peak force. Testing was performed for augmented screws as well as for nonaugmented screws. Conclusion: The stabilising effect of cement augmentation in pedicle screws might not be as beneficial as expected from biomechanical pullout tests. Lengthening of the dorsal instrumentation results in a much higher increase of stability during fatigue testing in the osteoporotic spine compared to cement augmentation.
Schlagworte
Cement augmentation
Continuous load
Fatigue test
Osteoporosis
Pedicle screws