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Die dezimierte Stabilit\u00e4t des Wirbelk\u00f6rpers f\u00fchrt h\u00e4ufig zu A\u2011Frakturen mit einem wesentlichen Einfluss bei der begleitenden Osteoporose. Eine mobilit\u00e4tserhaltende und schonende Therapie hat gegen\u00fcber der konservativen Behandlung deutliche Vorteile. Dabei hat sich die Hybridstabilisierung als Kombination der minimal-invasiven dorsalen Stabilisierung und einer Wirbelk\u00f6rperaugmentation etabliert. Im Zeitraum vom 01.07.2014 bis 30.06.2015 wurden 205 Wirbels\u00e4ulenoperationen erfasst. In der Gruppe der hochbetagten Patienten wurden \u00fcber 80\u202f% aufgrund einer geriatrischen Wirbelk\u00f6rperfraktur Typ\u00a0A behandelt und 24 mittels Hybridstabilisierung (77,1\u00a0Jahre, \u00b16,8), 5 perkutan-bisegmental (75,9\u00a0Jahre), 22\u00a0per Kyphoplastiestabilisierung (75,7\u00a0Jahre) und 13 perkutan-polysegmental versorgt (72,4\u00a0Jahre). Diese vier\u00a0Gruppen wurden ferner auch bez\u00fcglich der Behandlung im alterstraumatologischen Zentrum (ATZ) betrachtet. Die operative und perioperative Versorgung bei der Hybridstabilisierung war 36\u202fmin l\u00e4nger. Die vier Versorgungsformen erzielten eine durchschnittliche Verg\u00fctung von 11.238,77\u202f\u20ac. F\u00fcr die Versorgungsform Kyphoplastie zeigt sich bei \u00e4hnlichem Patientengut eine Steigerung in der Verg\u00fctung von 4276,54\u202f\u20ac, wenn die Patienten der geriatrischen Komplexbehandlung zugef\u00fchrt werden und dabei die DRG \u201eI34Z\u201c abgerechnet wird. Im Bereich der operativen Versorgung geriatrischer Wirbelk\u00f6rperfrakturen gelten die augmentiven Verfahren der Kypho- oder Vertebroplastie als etabliert, aber es zeigt sich h\u00e4ufig eine verletzungsbedingte Mitbeteiligung benachbarter Wirbels\u00e4ulensegmente und Anschlussfrakturen, sodass eine bisegmentale Hybridstabilisierung Vorteile zeigt. Da diese Wirbels\u00e4ulenpatienten durchschnittlich 15\u00a0Jahre \u00e4lter sind, wird in der geriatrischen Wirbels\u00e4ulenchirurgie der goldene Weg zwischen schonender Operationsmethode und fr\u00fchzeitigster Mobilisierung verfolgt. Zudem ist der perioperative Stress bei der Hybridstabilisierung nur unwesentlich l\u00e4nger, sodass die Hybridstabilisierung und die geriatrische Komplexbehandlung als neuer wirbels\u00e4ulenchirurgischer Versorgungsstandard f\u00fcr die Versorgung der A\u2011Frakturen hochbetagter Patienten empfohlen werden k\u00f6nnen.<\/jats:p>","DOI":"10.1007\/s00104-020-01136-4","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T09:03:27Z","timestamp":1583831007000},"page":"878-885","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Die Hybridstabilisierung und geriatrische Komplexbehandlung in der Therapie von A-Frakturen der Wirbels\u00e4ule","Hybrid stabilization and geriatric complex treatment of type A spinal fractures"],"prefix":"10.1007","volume":"91","author":[{"given":"L.","family":"Homagk","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Hellweger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. 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