Kyphoplasty / Vertebroplasty
Kyphoplasty and vertebroplasty are techniques for the treatment of a vertebral fracture due to osteoporosis or metastasis. Both techniques have an injection of bone cement into the affected vertebral body in common, often resulting in an immediate relief of pain. Additionally in kyphoplasty, however, an erection of the collapsed vertebra in the vertebral body is carried out with a balloon that is filled with liquid (contrast medium) under high pressure (will be filled up to 250 PSI), placed into the vertebral body. This creates a cavity in the vertebra, which is then filled, with a special technique, with bone cement.
This method is compared to many other techniques of cementing vertebral bodies very safe and poor in side effects, since the cement is not liquid but tough and is introduced with little pressure. In addition, the dreaded hump formation is being prevented through the erection.
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Now the Kyphoplasty is also possible in traumatic fractures in a younger age
So far, the treatment of painful vertebral fractures using kyphoplasty, was only possible for older patients because for the procedure only polymethyl methacrylate- (PMMA-) cements were available, whose long-term behavior in the vertebral body has not yet been adequately researched. According to current knowledge and experience, this cement is not built into the vertebral body, but remains rather isolated. A newly developed, injectable and resorbable calcium phosphate cement allows now the establishment and stabilization of traumatic and osteoporotic vertebral fractures, even for younger patients. Biomechanical studies have shown no significant differences in the capacity of these new cements to PMMA. Bio-cements are synthetic, biocompatible and biodegradable bone substitute materials, which belong to the group of osteoconductive bone substitute materials. The microcrystalline structure of the cured material corresponds in its chemical composition to the calcium phosphate component of natural bone: carbonated, calcium deficient hydroxyapatite. The expected long-term change in bone is seen as a clear advantage of calcium phosphate cements, which allows its use in traumatic and osteoporotic fractures for younger patients to prevent late complications. The additive use in combination with the dorsal instrumentation of more complex fractures, for a prevention of secondary sintering processes, has to be mentioned as well. The use of calcium phosphate cements in the kyphoplasty has to be regarded as a useful complement and expands the range of indications of the method significantly.
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