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Dorsale Stabilisierungstechniken bei subaxialen Verletzungen der Halswirbelsäule

Indikationen und Vorgehen

Posterior stabilization techniques for subaxial injuries of the cervical spine

Indications and approach

  • Leitthema
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Die Diskussion über die optimale Versorgung von subaxialen Verletzungen der Halswirbelsäule (HWS) wird kontrovers geführt, ein evidenzbasierter Goldstandard existiert nicht. Das gilt sowohl für die optimale initiale Strategie, insbesondere bei der Versorgung luxierter Verletzungen der HWS, aber auch für die sekundäre Stabilisierung. Moderne Schrauben-Stab-Systeme ermöglichen eine sichere und komplikationsarme dorsale Stabilisierungsoption speziell bei hoch instabilen Verletzungskonstellationen, sei es durch Schraubenplatzierung in der Massa lateralis oder in den Pedikeln. Dorsale Stabilisierungstechniken bieten dabei biomechanisch Vorteile gegenüber einer ventralen Stabilisierung und sind allein oder in Kombination mit ventraler Fusion eine wichtige Therapieoption in der Versorgung subaxialer Verletzungen der HWS.

Abstract

The optimal treatment strategy for lower cervical spine injuries is a matter of controversial discussion and no evidence-based gold standard exists. This is true for the optimal initial treatment, particularly in the treatment of dislocated injuries of the cervical spine as well as for secondary stabilization. Modern screw-rod systems provide a safe option for posterior stabilization with few complications, particularly for highly unstable injury constellations either by means of screw placement in the lateral mass of the atlas or in the pedicles. Posterior stabilization is biomechanically superior to anterior stabilization and is an important therapy option by itself or in combination with anterior stabilization in the treatment of subaxial cervical injuries.

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Authors and Affiliations

  1. Zentrum für Wirbelsäulenchirurgie, Klinik für Unfallchirurgie und Orthopädie, BG Klinik Ludwigshafen, Ludwig Guttmann Str. 13, 67071, Ludwigshafen, Deutschland

    K. Wendl, M. Kreinest, P. A. Grützner, A. Hogan & S. Matschke

Authors
  1. K. Wendl
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  2. M. Kreinest
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  3. P. A. Grützner
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  4. A. Hogan
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  5. S. Matschke
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Corresponding author

Correspondence to K. Wendl.

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Interessenkonflikt

K. Wendl, M. Kreinest, P.A. Grützner, A. Hogan und S. Matschke geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Wendl, K., Kreinest, M., Grützner, P.A. et al. Dorsale Stabilisierungstechniken bei subaxialen Verletzungen der Halswirbelsäule. Trauma Berufskrankh 18, 261–267 (2016). https://doi.org/10.1007/s10039-016-0214-x

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  • DOI: https://doi.org/10.1007/s10039-016-0214-x

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