Fragility fractures of the spine

Excerpt

The number of the elderly population in the industrial countries has been growing over the last decades and will continuously be growing in the future. Reduced bone quality leads to rising numbers of fragility fractures. The treatment principles are varying and despite a huge number of literature optimal treatment algorithms remain controversial. Modern conservative treatment includes early mobilization and pain relief; radiological controls are important. If surgery is indicated, one can choose from a large pool of treatment options: cement augmentation alone, combined with stents or inserted after preparation of the vertebra by balloons or similar expanding techniques. Modern cements have been developed with optimized viscosity [1]. For unstable situations instrumentation may be indicated. In these cases the screws may be used cement augmented. This technique may also be advantageous for revision operations. In some cases combined posterior and anterior fusion may be indicated also in the elderly population resulting in challenging situations and possible higher complication rates. The Section Spine of the German Society of Orthopedics and Trauma Surgery (DGOU) has recognized the importance of the fragility fractures on the spine and founded a task force searching for new classifications and treatment algorithms [2]. …