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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Operative treatment of osteoporotic vertebral body fracture – a comparison of different options

Die operative Behandlung von osteoporotischen Wirbelkörperfrakturen – ein Vergleich verschiedener Therapiemöglichkeiten

Meeting Abstract

  • presenting/speaker Maren Klausnitzer - Universitätsklinikum Jena, Neurochirurgie, Jena, Deutschland
  • Falko Schwarz - Universitätsklinikum Jena, Neurochirurgie, Jena, Deutschland
  • Albrecht Waschke - Universitätsklinikum Jena, Neurochirurgie, Jena, Deutschland
  • Rolf Kalff - Universitätsklinikum Jena, Neurochirurgie, Jena, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP147

doi: 10.3205/19dgnc484, urn:nbn:de:0183-19dgnc4848

Published: May 8, 2019

© 2019 Klausnitzer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: The older the population gets the prevalence of osteoporotic body fractures rises. In consequence, more patients undergo surgery despite many comorbidities. Target of this examination is to compare different surgical procedures dependent on the osteoporosis fracture (OF) classification.

Methods: It is a matter of reotrospective overview of 3 surgical methods applied in 131 patients. The median age was 74 years (range 41–92). 42 (32.1%) were male. 89 fracutres were treated by kyphoplasty (KY), 24 patients were operated by hybrid stabilisation (HV, means kyphoplasty of fractured vertebra combinated with a cement augmented fixateur interne). 18 patients had a vertebral body replacement (WK). All operation procedures were compared by different factors and based on the results a recommendation was drawn up.

Results: Kyphoplasty was the therapy of choice for bone bruise (OF1) and ceiling plate impression fractures (OF2). Hybrid treatment was primarily used for fractures with greater involvement of the posterior wall (OF3) and pincer fractures (OF4) (n=16). A anterior vertebral body replacement was performed in most cases with pronounced fractures (OF4, n=14; OF5, n=2). The median age and bone density in the KY group were 74 and a T value of -3.7, in the HV group 75 years and T=-3.8, and in the WK group 66.5 years and T=-3.2, respectively. Surgically treatable complications did not occur in the HV group, 8 patients in the KY group (8.9%), and 4 patients in the WK group (22.2%).

Conclusion: With more severe vertebral body, fractures a more invasive surgical method was necessary. Thereby the number of complications increased. But despite the high age of the patients and many comorbidities there are rare contraindications for a surgical procedure. Because of that fact surgery should be considered.