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Operationsverfahren zur Stabilisierung der oberen Halswirbelsäule

Surgical procedures to stabilize the upper cervical spine

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Zusammenfassung

Die operativen Therapieoptionen zur Behandlung von Verletzungen der oberen Halswirbelsäule haben in den letzten Jahren erheblich zugenommen. Dabei können 2 Formen der operativen Stabilisierung unterschieden werden: Osteosyntheseverfahren dienen der Rekonstruktion verletzter Strukturen mit dem Ziel, die Beweglichkeit der oberen Halswirbelsäule zu erhalten. Bei den Spondylodeseverfahren, die atlantoaxial oder okzipitoatlantoaxial vorgenommen werden können, ist das Ziel der Operation hingegen die Stabilität der oberen Halswirbelsäule durch „Versteifung“ wiederherzustellen. Die Operationsverfahren für beide Therapieprinzipien werden im vorliegenden Beitrag hinsichtlich ihrer Indikationen, Technik und Komplikationen beschrieben.

Abstract

The options for surgical treatment of injuries to the upper cervical spine have increased considerably in recent years. A distinction can be made between two forms of surgical stabilization. Techniques of osteosynthesis serve to reconstruct the injured structure with the goal of maintaining mobility of the upper cervical spine. A spondylodesis, that can be performed at the atlantoaxial or occipitoatlantoaxial joint, aims to stabilize the upper cervical spine by fusion techniques. This article describes the surgical procedures for both treatment principles with regard to the indications, techniques, and complications.

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Kandziora, F., Schnake, K. & Hoffmann, R. Operationsverfahren zur Stabilisierung der oberen Halswirbelsäule. Unfallchirurg 113, 845–859 (2010). https://doi.org/10.1007/s00113-010-1863-z

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