The Osteoporotic Spine

Osteoporotic fractures and the resulting deformities are a problem that we see with increasing frequency.

The affected patients are often severely pain-ridden and immobilized, while at the same time carrying a significant perioperative risk, depending on age and comorbidities.

These patients pose some of the biggest challenges when deciding on how much or how little can and should be done in each individual case.

The treatment strategies can be completely conservative with customized bracing, advanced diagnostics and medical treatment for osteoporosis, for which we closely collaborate with the Internal Medicine Department.

Painful and/or unstable osteoporotic vertebral fractures can be treated by injecting bone cement through a percutaneously placed needle.

When the fractured vertebra is deformed with a large angle between the endplates, kyphoplasty can be used to correct this deformity.

Otherwise, vertebroplasty – the simple injection of bone cement – is perfectly sufficient.

When more stability is required than vertebroplasty or kyphoplasty alone can provide, we use special pedicle screw systems that can be augmented with bone cement in order to increase purchase in osteoporotic bone.

In some cases with severe instabilities, anterior reconstruction may also be required and in the most severe cases, even osteotomies are needed in order to restore sagittal balance.

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German Medical Journal

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