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DOI: 10.1055/a-1926-0888
Zement am Becken: Wohl oder Wehe?
Indikationen und Grenzen der pelvinen ZementaugmentationCement to the Pelvis: Weal or Woe?Indications and Limits of Pelvic Cement AugmentationZusammenfassung
Einleitung Pathologische Knochenmorphologie und Frakturen, sei es durch osteoporotische Veränderungen oder bösartige Prozesse, erfordern besonders stabile, im Idealfall auch minimalinvasive Osteosyntheseverfahren. Die additive Nutzung von Knochenzement hat hier Vor- aber auch Nachteile. Ziel dieses Literaturreviews ist es daher, die führenden Indikationen sowie Vor- und Nachteile für die Zementapplikation am Becken näher zu beleuchten.
Material und Methoden Es wurde eine PubMed-Recherche mit Fokus auf die Suchbegriffe „cement, pelvic“ durchgeführt (648 Einträge) und die für die vorliegende Fragestellung besonders relevanten Artikel wurden ausgewertet.
Ergebnisse und Diskussion Die aktuelle Literatur setzt sich im Wesentlichen mit folgenden 4 Themenfeldern auseinander: Zementoplastie, Zementaugmentation sakroiliakaler Schrauben bzw. iliakaler Schrauben und perkutane Fixierung durch interne zementierte Schraube. Es zeigt sich – bei strenger Indikationsstellung – eine weitgehend zuverlässige, sichere und zumeist minimalinvasive Anwendbarkeit von Zement bei o. g. Techniken, die eine niedrige Komplikationsrate aufweisen.
Abstract
Introduction Pathological bone morphology and fractures, whether due to osteoporotic changes or malignant processes, require particularly stable and ideally minimally invasive osteosynthesis procedures. The additive use of bone cement offers both advantages and disadvantages. The aim of this literature review is therefore to shed more light on the leading indications as well as advantages and disadvantages for the application of cement to the pelvis.
Material and methods A PubMed search was carried out with a focus on the search terms "cement, pelvic" (648 entries) and the articles particularly relevant to the present research question were evaluated.
Results and discussion The current literature mainly deals with the following four topics: cementoplasty, cement augmentation of sacroiliac screws or iliac screws and percutaneous fixation with internal cemented screws. It shows – with strict indication – a largely reliable, safe and mostly minimally invasive application of cement in the above mentioned techniques that have a low complication rate.
Schlüsselwörter
Zementaugmentation - Zementoplastie - sakroiliakale Schrauben - iliakale Schrauben - perkutane Fixierung - BeckenKeywords
cement augmentation - cementoplasty - sacroiliac screws - iliac screws - percutaneous fixation - pelvicPublication History
Article published online:
24 October 2023
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Literatur
- 1 Rommens PM, Hofmann A. Comprehensive classification of fragility fractures of the pelvic ring: recommendations for surgical treatment. Injury 2013; 44: 1733-44 DOI: 10.1016/j.injury.2013.06.023. (PMID: 23871193)
- 2 Benhabib H, Meirovich H, David E. Evolving role of minimally invasive techniques in the management of symptomatic bone metastases. Curr Opin Support Palliat Care 2021; 15: 91-98 DOI: 10.1097/SPC.0000000000000548. (PMID: 33905381)
- 3 Garnon J, Meylheuc L, Cazzato RL. et al. Percutaneous extra-spinal cementoplasty in patients with cancer: A systematic review of procedural details and clinical outcomes. Diagn Interv Imaging 2019; 100: 743-752 DOI: 10.1016/j.diii.2019.07.005 . (PMID: 31427218)
- 4 Moser TP, Onate M, Achour K. et al. Cementoplasty of pelvic bone metastases: systematic assessment of lesion filling and other factors that could affect the clinical outcomes. Skeletal Radiol 2019; 48: 1345-1355 DOI: 10.1007/s00256-019-3156-0. (PMID: 30712119)
- 5 Liu HF, Wu CG, Tian QH. et al. Application of Percutaneous Osteoplasty in Treating Pelvic Bone Metastases: Efficacy and Safety. Cardiovasc Intervent Radiol 2019; 42: 1738-1744 DOI: 10.1007/s00270-019-02320-8. (PMID: 31549190)
- 6 Park JW, Lim HJ, Kang HG. et al. Percutaneous Cementoplasty for the Pelvis in Bone Metastasis: 12-Year Experience. Ann Surg Oncol 2022; 29: 1413-1422 DOI: 10.1245/s10434-021-10640-8. (PMID: 34448054)
- 7 Key BM, Scheidt MJ, Tutton SM. Advanced Interventional Pain Management Approach to Neoplastic Disease Outside the Spine. Tech Vasc Interv Radiol 2020; 23: 100705 DOI: 10.1016/j.tvir.2020.100705. (PMID: 33308576)
- 8 Lodde MF, Katthagen JC, Schopper CO. et al. Does Cement Augmentation of the Sacroiliac Screw Lead to Superior Biomechanical Results for Fixation of the Posterior Pelvic Ring? A Biomechanical Study. . Medicina (Kaunas) 2021; 57: 1368 DOI: 10.3390/medicina57121368 . (PMID: 34946313)
- 9 Suero EM, Greiner A, Becker CA. et al. Biomechanical stability of sacroiliac screw osteosynthesis with and without cement augmentation. Injury. 2021 52: 2707-2711 DOI: 10.1016/j.injury.2020.01.043. (PMID: 32033807)
- 10 König A, Oberkircher L, Beeres FJP. et al. Cement augmentation of sacroiliac screws in fragility fractures of the pelvic ring-A synopsis and systematic review of the current literature. Injury 2019; 50: 1411-1417 DOI: 10.1016/j.injury.2019.06.025. (PMID: 31301810)
- 11 Hartensuer R, Lodde MF, Keller J. et al. Safety, Effect and Feasibility of Percutaneous SI-Screw with and without Augmentation-A 15-Year Retrospective Analysis on over 640 Screws. J Clin Med 2020; 9: 2660 DOI: 10.3390/jcm9082660. (PMID: 32824548)
- 12 Hack J, Safi M, Bäumlein M. et al. Is cement-augmented sacroiliac screw fixation with partially threaded screws superior to that with fully threaded screws concerning compression and pull-out force in fragility fractures of the sacrum? - a biomechanical analysis.. BMC Musculoskelet Disord 2021; 22: 1034 DOI: 10.1186/s12891-021-04933-y. (PMID: 34893059)
- 13 Oberkircher L, Masaeli A, Hack J. et al. Pull-out strength evaluation of cement augmented iliac screws in osteoporotic spino-pelvic fixation. Orthop Traumatol Surg Res 2021; 107: 102945 DOI: 10.1016/j.otsr.2021.102945. (PMID: 33895387)
- 14 Decker S, Meyer M, Müller CW. et al. Cement augmentation as revision strategy for loosened thick-diameter non-fenestrated iliac screws - A biomechanical analysis. Clin Biomech (Bristol, Avon) 2019; 65: 41-44 DOI: 10.1016/j.clinbiomech.2019.04.001. (PMID: 30959349)
- 15 Deschamps F, Yevich S, Gravel G. et al. Percutaneous Fixation by Internal Cemented Screw for the Treatment of Unstable Osseous Disease in Cancer Patients. Semin Intervent Radiol 2018; 35: 238-247 DOI: 10.1055/s-0038-1673359. (PMID: 30402006)
- 16 Roux C, Tselikas L, Yevich S. et al. Fluoroscopy and Cone-Beam CT-guided Fixation by Internal Cemented Screw for Pathologic Pelvic Fractures. Radiology 2019; 290: 418-425 DOI: 10.1148/radiol.2018181105. (PMID: 30422090)
- 17 Moulin B, Tselikas L, De Baere T. et al. CT guidance assisted by electromagnetic navigation system for percutaneous fixation by internal cemented screws (FICS). Eur Radiol 2020; 30: 943-949 DOI: 10.1007/s00330-019-06408-0. (PMID: 31478088)
- 18 Assouline J, Tselikas L, Roux C. et al. Prophylactic Percutaneous Consolidation of Large Osteolytic Tumors of the Pelvic Ring Using Fixation by Internal Cemented Screws. Radiol Imaging Cancer 2021; 3: e200137 DOI: 10.1148/rycan.2021200137. (PMID: 33988476)