title: [Complex Pathologies of the Spine: Trauma meets Degeneration].
abstract: Treating vertebral body fractures is challenging when there is relevant pre-existing spinal degeneration. Both vertebral body fractures and spinal degeneration are related to the physiological aging process. The increases in both are linked to increases in life expectancy. Several factors promote spinal degeneration and increase fracture risk, such as disc degeneration, spinal imbalance and osteoporosis. The main diagnostic and therapeutic challenge is to identify the sources of pain and to start appropriate therapy. A structured and advanced algorithm is then essential. Unstable fractures must always be stabilised. However, surgical strategy may be greatly influenced if there are also degenerative diseases, such as segmental decompression, multisegmental instrumentation or fusion, or complex reconstructive spondylodesis, including osteotomies. Notwithstanding this, the individual therapy concept has to be adapted to the demands and pathology of the individual patient.
authors.affiliation: Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig.
authors.forename: C
authors.initials: C
authors.lastname: Josten
authors.affiliation: Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig.
authors.forename: C-E
authors.initials: CE
authors.lastname: Heyde
authors.affiliation: Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig.
authors.forename: U J
authors.initials: UJ
authors.lastname: Spiegl
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods*; D019317:Evidence-Based Medicine; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007796:Laminectomy / Q000379:methods; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome