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Traumatologie der Wirbelsäule

Traumatology of the spine

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Zusammenfassung

Wirbelsäulenverletzungen stellen eine besonders lebens- und lebensqualitätsbedrohende Unfallfolge dar. Insbesondere bei Verletzungen der Halswirbelsäule sind Schäden des Myelons bis hin zum kompletten Querschnitt nicht selten. Eine gründliche Diagnostik, die häufig eine Computertomographie erfordert, erschließt Ausmaß und Behandlungsbedarf der Verletzung. Ziel jeder Therapie ist die Wiederherstellung der Stabilität der Wirbelsäule und die Verhütung einer sekundären neurologischen Verschlechterung. Im Bereich der Brust- und Lendenwirbelsäule können die meisten einfachen Kompressionsfrakturen konservativ behandelt werden, während isolierte Berstungsfrakturen meistens und Flektions-Distraktions-Verletzungen oder Rotationsberstungsbrüche regelmäßig einer operativen Stabilisierung mittels dorsaler Instrumentierung und ventraler Spondylodese bedürfen. Verletzungen der oberen Halswirbelsäule (HWS) werden in Abhängigkeit der Stabilität durch äußere Retention oder operative Reposition behandelt, im Bereich der unteren HWS ist meistens die operative Stabilisierung erforderlich.

Abstract

Spinal trauma poses considerable threats to survival and quality of life. Especially cervical spine injuries are often associated with neurologic deficits. A thorough diagnostic pathway, often including computed tomography with sagittal reconstruction, is mandatory to evaluate the extent and consequences of spinal trauma. Every treatment must aim to restore stability and prevent secondary neurologic deterioration. Compression fractures usually can be treated successfully with conservative treatment, while burst fractures usually, and flexion/distraction injuries, and fracture-dislocation generally require internal stabilization. Injuries of the upper cervical spine can be treated conservatively or operatively, depending on the degree of instability. In the lower cervical spine, most injuries require internal fixation.

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  1. Abt. Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland

    C.W. Müller, T. Hüfner, T. Gösling & C. Krettek

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  1. C.W. Müller
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  2. T. Hüfner
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  3. T. Gösling
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  4. C. Krettek
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Correspondence to C.W. Müller.

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Müller, C., Hüfner, T., Gösling, T. et al. Traumatologie der Wirbelsäule. Chirurg 79, 918–926 (2008). https://doi.org/10.1007/s00104-008-1517-7

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