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Die Ballonkyphoplastie in der Behandlung des Rückenschmerzes

Balloonkyphoplasty in the treatment of back pain

  • Rückenschmerz: Diagnostik und Intervention
  • Published:
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Zusammenfassung

Hintergrund

Die Ballonkyphoplastie hat nach der bisherigen Erfahrung von knapp 5 Jahren bewiesen, dass sie ebenso wie die deutlich länger etablierte Vertebroplastie den Rückenschmerz aufgrund frischer und älterer osteoporotischer sowie frischer traumatischer Frakturen erfolgreich zu behandeln vermag.

Material und Methode

Bei 345 Patienten mit insgesamt 690 behandelten Wirbelkörpern wurde die Veränderung der Schmerzsymptomatik von 40 kyphoplastierten Studienpatienten und einer Kontrollgruppe von 20 Patienten über eine Nachbeobachtungszeit von 12 Monaten analysiert. Darüber hinaus wurden die Schmerzen weiterer 29 Patienten mit frischen traumatischen Wirbelkörperfrakturen über 12 Monate verfolgt. Diese Frakturen wurden teils mit Fixateur interne allein oder in Kombination von Fixateur interne und Ballonkyphoplastie behandelt.

Ergebnisse

Die 40 kyphoplastierten Patienten zeigten im VAS-Score einen Ausgangswert von 26,2±2,00 und nach 12 Monaten einen Anstieg auf 44,4±3,11, die Kontrollgruppe hatte Werte von 33,6±4,21 bzw. 34,3±4,35. Bei den 29 frischen traumatischen Wirbelkörperfrakturen zeigte sich ein VAS-Score von initial 62 und nach 12 Monaten eine deutliche Schmerzreduktion auf 20 (100 = maximaler Schmerz, 0 = kein Schmerz). Die Zahl der Hausarztbesuche der 40 kyphoplastierten Patienten konnte durch die Schmerzbehandlung signifikant reduziert werden.

Schlussfolgerung

Die Ballonkyphoplastie hat nach Wirbelfrakturen die Schmerzsymptomatik über einen Zeitraum von 12 Monaten nachweisbar deutlich verbessert. Der Vergleich mit der Kontrollgruppe, die die gleiche medikamentöse Osteoporosetherapie erhielt, bestätigte den Effekt dieser minimalinvasiven Behandlungsform.

Abstract

Background

Experience of just under 5 years has shown that balloon kyphoplasty can be just as successfully employed as the longer-stablished vertebroplasty for the treatment of back pain due to recent or prior osteoporotic fractures as well as new traumatic fractures.

Material and method

Among 345 patients with a total of 690 treated vertebral bodies, the change in pain symptomatology was analyzed for a follow-up period of 12 months in 40 study patients who underwent kyphoplasty and a control group of 20 patients. In addition, the pain experienced by a further 29 patients with new traumatic vertebral body fractures was monitored over a 12-month period. These fractures were partly managed by fixateur interne alone and by a combination of fixateur interne and kyphoplasty.

Results

The 40 patients treated by kyphoplasty had a baseline VAS score of 26.2±2.00, which increased to 44.4±3.11 after 12 months, while the respective scores for the control group were 33.6±4.21 and 34.3±4.35. In the 29 patients with new traumatic vertebral body fractures, the initial VAS score was 62 and after 12 months a distinct reduction of pain was noted with a score of 20 (100 = maximum pain, 0 = no pain). The number of times that the 40 patients managed by kyphoplasty had to consult their general practitioner was significantly reduced by the pain therapy.

Conclusion

Balloon kyphoplasty verifiably improved the pain symptomatology after vertebral fracture over a period of 12 months. Comparison with the control group, which received the same osteoporosis drug therapy, confirmed the effect of this minimally invasive treatment form.

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Authors and Affiliations

  1. Abteilung Radiodiagnostik, Radiologische Universitätsklinik, Im Neuenheimer Feld 110, 69120 , Heidelberg

    G. Nöldge, M. Libicher & G. W. Kauffmann

  2. Abteilung Unfall- und Wiederherstellungschirurgie, Chirurgische Klinik der Universität Heidelberg

    K. DaFonseca & P.-J. Meeder

  3. Abteilung Osteologie, Medizinische Klinik I der Universität Heidelberg

    I. Grafe & C. Kasperk

  4. Abteilung für Unfall- und orthopädische Chirurgie, St.-Vincenz-Krankenhaus Limburg

    J. Hillmeier

Authors
  1. G. Nöldge
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  2. K. DaFonseca
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  3. I. Grafe
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  4. M. Libicher
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  5. J. Hillmeier
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  6. P.-J. Meeder
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  7. G. W. Kauffmann
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  8. C. Kasperk
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Correspondence to G. Nöldge.

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Nöldge, G., DaFonseca, K., Grafe, I. et al. Die Ballonkyphoplastie in der Behandlung des Rückenschmerzes. Radiologe 46, 506–512 (2006). https://doi.org/10.1007/s00117-006-1384-5

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  • DOI: https://doi.org/10.1007/s00117-006-1384-5

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