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Augmentation von Wirbelkörperfrakturen mit einem neuen Calciumphosphat-Zement nach Ballon-Kyphoplastie

  • Leitthema
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Zusammenfassung

Fragestellung

Sind Schmerzreduktion und Funktionsverbesserung bei Kyphoplastie unter Verwendung des nicht toxischen Calcibon ebenso gut wie mit Polymethylmethacrylat (PMMA)?

Patienten und Methode

In einer prospektiven interdisziplinären Monocenterstudie wurden 99 Patienten (173 Wirbelkörper, „WK“) mit osteoporotischen und traumabedingten Frakturen von 12/2001–3/2003 mit Kyphoplastie behandelt. Bei 66 Patienten (127 WK) führten wir die Augmentation mit PMMA , bei 33 (46 WK) mit Calcibon durch. Nachuntersucht wurde klinisch mit einem VAS-Schmerz- und Funktionsscore und radiomorphometrisch mit Nativ-Röntgen und CT.

Ergebnisse

Schmerz und Funktion besserten sich bei 87% der Patienten—bei einer durchschnittlichen Aufrichtung der mittleren WK-Höhe von 16%. Die Zementaustrittsrate lag bei Verwendung von PMMA bei 9% und bei Calcibon mit modifizierter Injektionstechnik bei 10%. Schmerz, Funktion und Radiomorphometrie zeigten in der 6-Monats-Kontrolle keine signifikanten Unterschiede.

Fazit

Die Kyphoplastie ist ein zuverlässiges und sicheres minimal-invasives Verfahren zur Stabilisierung frakturierter WK. Nach Augmentation mit Calcibon wird eine gute Schmerzreduktion, Funktionsverbesserung und Aufrichtung der behandelten WK erzielt.

Abstract

Question

Can the same levels of pain reduction and increase in function be achieved in kyphoplasty procedures with Calcibon as with polymethylmethacrylate (PMMA) cement?

Patients and methods

In a prospective, interdisciplinary single-center study, 99 patients (173 vertebral fractures) were treated with kyphoplasty. Augmentation was performed with PMMA in 66 cases (127 vertebral bodies) and with Calcibon in 33 patients (46 vertebral bodies). Outcome data were obtained with a VAS spine score and by radiomorphometric evaluation of X-rays before and after treatment.

Results

Pain and function improved in 87% of the patients; an average of 16% of the lost vertebral height was regained. A 9% cement leakage rate was observed with PMMA and 10% with Calcibon. There was no significant difference in pain reduction and radiomorphometric evaluation between the two techniques.

Conclusion

Kyphoplasty is a reliable, minimally invasive method to stabilize fractured vertebral bodies. Augmentation with Calcibon improves pain and function and enables the treated vertebral body to regain of height.

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Authors and Affiliations

  1. Abteilung für Unfall-und orthopädische Chirurgie, St.-Vincenz-Krankenhaus, Limburg

    J. Hillmeier

  2. Sektion Unfall-und Wiederherstellungschirurgie, Chirurgische Klinik der Universität Heidelberg, Heidelberg

    P. J. Meeder, H. J. Kock & K. Da Fonseca

  3. Sektion internistische Röntgendiagnostik, Abteilung Radiodiagnostik der Universität Heidelberg, Heidelberg

    G. Nöldge

  4. Sektion Osteologie, Innere Medizin 1 der Universität Heidelberg, Heidelberg

    H. C. Kasperk

  5. Abteilung für Unfall- und orthopädische Chirurgie, St.-Vincenz-Krankenhaus, Auf dem Schafsberg, 65549 , Limburg

    J. Hillmeier

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  1. J. Hillmeier
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  2. P. J. Meeder
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  3. G. Nöldge
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  4. H. J. Kock
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  5. K. Da Fonseca
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  6. H. C. Kasperk
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Correspondence to J. Hillmeier.

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Hillmeier, J., Meeder, P.J., Nöldge, G. et al. Augmentation von Wirbelkörperfrakturen mit einem neuen Calciumphosphat-Zement nach Ballon-Kyphoplastie. Orthopäde 33, 31–39 (2004). https://doi.org/10.1007/s00132-003-0578-z

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  • DOI: https://doi.org/10.1007/s00132-003-0578-z

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