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Review
. 2022 Jun;125(6):460-466.
doi: 10.1007/s00113-022-01188-7. Epub 2022 May 23.

[Cement augmentation in spinal surgery]

[Article in German]
Philipp Schleicher  1 , Alexander Wengert  2 , Jonathan Neuhoff  2 , Frank Kandziora  2
Affiliations
Review

[Cement augmentation in spinal surgery]

[Article in German]
Philipp Schleicher et al. Unfallchirurgie (Heidelb). 2022 Jun.

Abstract
in English, German

Bone cement has been used in spinal surgery for as long as 50 years. In contemporary spinal surgery, cement augmentation of fractured osteoporotic vertebrae in the form of vertebroplasty/kyphoplasty as well as cement augmentation of pedicle screws in instrumented procedures of any etiology are established as standard procedures. Both procedures are very effective, although the benefits of vertebroplasty/kyphoplasty procedures have been controversially discussed in the past. Overall, complications rarely occur. The most relevant complication is cement leakage, which is asymptomatic in the majority of cases but in the worst case might lead to neurological deficits, embolic events and even circulatory collapse. Prevention of cement leakage is therefore crucial. Risk factors for cement leakage and preventive measures are presented in a comprehensive review based on the available literature.

Knochenzement wird an der Wirbelsäule schon seit 50 Jahren verwendet. In der modernen Wirbelsäulenchirurgie sind die Zementaugmentation osteoporotisch frakturierter Wirbelkörper in Form der Vertebroplastie/Kyphoplastie sowie die Zementaugmentation von Pedikelschrauben bei instrumentierten Eingriffen jedweder Ätiologie als Standardverfahren etabliert. Beide Verfahren sind sehr effektiv, wobei der Nutzen der Vertebroplastie/Kyphoplastie in der Vergangenheit sehr kontrovers diskutiert wurde. Insgesamt treten selten Komplikationen auf. Die relevanteste Komplikation ist die Zementleckage, die in der Mehrzahl der Fälle asymptomatisch bleibt, im schlimmsten Fall aber auch neurologische Schäden oder embolische Ereignisse bis hin zum Kreislaufversagen nach sich ziehen kann. Der Prophylaxe der Zementextravasation kommt daher überragende Bedeutung zu. Risikofaktoren für die Zementleckage und vorbeugende Maßnahmen werden anhand der vorhandenen Literatur in einem umfassenden Review dargestellt.

Keywords: Bone cements; Cement leakage; Implant fixation; Osteoporosis; Spinal fractures.

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References

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