Percutaneous vertebral augmentation in fragility fractures-indications and limitations.

Introduction: There is still no general consensus about the management of osteoporotic vertebral fractures. Recommendations depend on type of fracture, grade of instability, bone quality, and general conditions of the patient. Spontaneous fractures may be considered to be treated different compared...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 43; no. 1; pp. 9 - 18
Autores principales: Gonschorek, O., Hauck, S., Weiß, T., Bühren, V.
Formato: diagnostic images Journal Article
Publicado: Springer Nature Feb2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2017
      vid: 43
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-016-0753-7
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        atl: Percutaneous vertebral augmentation in fragility fractures-indications and limitations.
      aug:
        au:
          Gonschorek, O.
          Hauck, S.
          Weiß, T.
          Bühren, V.
        affil: Department of Spine Surgery , BGU Trauma Center , Prof. Küntscher Str. 8 82418 Murnau Germany
      sug:
        subj:
          Vertebroplasty
          Spinal Fractures Therapy
          Bone Cements
          Fractures, Spontaneous Therapy
          Vertebroplasty Adverse Effects
          Fractures, Spontaneous
          Human
          Kyphoplasty
          Tomography, X-Ray Computed
          Lumbar Vertebrae
          Osteoporosis
          Pain
          Osteoporotic Fractures
      ab: Introduction: There is still no general consensus about the management of osteoporotic vertebral fractures. Recommendations depend on type of fracture, grade of instability, bone quality, and general conditions of the patient. Spontaneous fractures may be considered to be treated different compared to cases with high-velocity trauma. Methods: According to the DVO, patients without trauma should first be treated conservatively. However, there is no more strict time protocol of 3 or 6 week conservative treatment before operations may be indicated. Surgical criteria are not yet distinctly defined. For highly unstable fractures (type B and C according to the AO Spine Classification), posterior instrumentation with cement augmented screws and as long construct, respectively, is adequate. Current literature has been analysed for diagnostic and therapeutic protocols. Results: There is no clear operative concept for burst fractures and classic osteoporotic fractures with dynamic ongoing sintering. Percutaneous vertebral augmentation showed to prevent the fractures from ongoing kyphotic deformity and the patients from painful immobilization. Indications and results of classical vertebroplasty and kyphoplasty have been discussed intensively in the literature. Further development included special injection techniques, cements with different viscosities and stenting systems to reach more stable constructs and avoid typical complications, such as cement extrusion. Conclusions: This review reports upon indications and limitations of percutaneous vertebral augmentation and the potential development of classifications and therapeutic algorithms.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        Journal Article
      ougenre: Article
    language: English
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