Laurer H, Sander A, Wutzler S, Nau C, Marzi I
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität, 60590, Frankfurt a.M., Deutschland.
Orthopade. 2010 Jul;39(7):704-10. doi: 10.1007/s00132-010-1601-9.
Traumatic vertebral body fractures are different from the osteoporotic vertebral sintering fractures with regard to accruement, classification and surgical treatment. The standard therapeutic regimen for traumatic vertebral fracture implies sufficient analgetic as well as antiosteoporotic medication and physiotherapy. In cases of A1 fractures and A2.1/A2.2 fractures, minimally invasive treatment strategies have proven to be appropriate treatment options when conservative treatment fails. Unstable fractures, the presence of neurological deficits or stenosis of the canal require conventional operative treatment. Due to reduced bone quality and age-dependent biomechanical changes, distinct operative procedures and strategies - cement augmentation of pedicle screws, additional cement augmentation of the fractured vertebra - for complex traumatic vertebral fractures have been established.
创伤性椎体骨折在成因、分类及手术治疗方面与骨质疏松性椎体压缩骨折不同。创伤性椎体骨折的标准治疗方案包括充分的止痛及抗骨质疏松药物治疗和物理治疗。对于A1型骨折以及A2.1/A2.2型骨折，当保守治疗失败时，微创治疗策略已被证明是合适的治疗选择。不稳定骨折、存在神经功能缺损或椎管狭窄则需要进行传统手术治疗。由于骨质质量下降和年龄相关的生物力学变化，针对复杂创伤性椎体骨折已确立了不同的手术方法和策略——椎弓根螺钉骨水泥强化、骨折椎体额外的骨水泥强化。
