Surgical measures
- Frequently, after fractures (broken bones), surgical therapy must be performed to restore the stability of the bone. This mainly concerns fractures of the hip and thigh.
- For fractures of the vertebral bodies, the type of therapy depends on whether the fracture is stable or unstable. More than 33% of vertebral body fractures lead to persistent discomfort as a result of spinal deformity. Surgical measures are used to decompress the spinal canal and the outgoing nerve roots, and to stabilize and realign deformed vertebral bodies.In stable fractures, it is usually sufficient to wear orthoses (orthopedic aids that are worn on the outside of the body as a support apparatus). For unstable fractures or those that narrow the spinal canal, surgical therapy consists of decompression and stabilization of the spine (percutaneous vertebroplasty or kyphoplasty, which is a modification of vertebroplasty):
- Percutaneous vertebroplasty (PV) is a minimally invasive medical procedure used to treat fractures of the vertebral bodies. Initially intended only to stabilize osteoporotic vertebral body fractures (sintered fractures), PV is also increasingly used, for example, for metastases (daughter tumors) in vertebral bodies. PV immediately relieves the pain of a vertebral fracture. Mobility is improved, and patients’ need for analgesia is reduced.Additional notes.
- Vertebroplasty performed early is more effective than placebo intervention for acute painful osteoporotic vertebral fractures in elderly patients (mean age 80 years).
- Sham surgery performed under local anesthesia produced similar good results to vertebroplasty for acute osteoporotic vertebral fracture. Conclusion of this study: in acute osteoporotic compression fractures, vertebroplasty should be avoided.
- Vertebroplasty should be refrained from, if necessary, in patients with vertebral fractures and lack of neurological limitation.
- Vertebroplasty is to be refrained from, if necessary, in patients with vertebral fractures and lack of neurological limitation.Possible complication after vertebroplasty: cement embolism in the lungs due to bone cement leakage:A postmortem evaluation was able to demonstrate leakage in 69% of all cases: 36% intravenous, 32% intervertebral, the rest intraspinal or retrograde.
- Kyphoplasty is a minimally invasive medical procedure used to treat fractures of the vertebral bodies. Two balloons are inserted into the fractured vertebral body through small cannulas with a diameter of about 4 mm. By filling the balloons with a contrast medium, the collapsed vertebral body is straightened. Subsequently, this erection is fixed by injecting a bone cement into the resulting cavity, which hardens within a few minutes and thus stabilizes the vertebral body fracture (fractured vertebral body).
- Percutaneous vertebroplasty (PV) is a minimally invasive medical procedure used to treat fractures of the vertebral bodies. Initially intended only to stabilize osteoporotic vertebral body fractures (sintered fractures), PV is also increasingly used, for example, for metastases (daughter tumors) in vertebral bodies. PV immediately relieves the pain of a vertebral fracture. Mobility is improved, and patients’ need for analgesia is reduced.Additional notes.
