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Operative Therapie an der Halswirbelsäule bei rheumatoider Arthritis

Diagnostik und Indikation

Surgery of the cervical spine in rheumatoid arthritis. Diagnostics and indication

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Zusammenfassung

Die Halswirbelsäule ist häufig bei rheumatoider Arthritis befallen. Dabei kann es neben destruktiven Veränderungen zu Instabilitäten kommen, welche bevorzugt im oberen HWS-Bereich auftreten. Typische Symptome fehlen, sodass routinemäßige Röntgenuntersuchungen notwendig sind, um schwerwiegende Folgen bis hin zum letalen Ausgang zu vermeiden. HWS in 2 Ebenen und seitliche Röntgenfunktionsaufnahmen stellen dabei den Standard dar. Befundabhängig muss eine weiterführende neurologische und kernspintomographische Diagnostik eingeleitet werden. Ziel stellt das frühzeitige Erkennen bzw. die Vermeidung einer Myelopathie dar. Die Therapie besteht befundabhängig sowohl aus konservativen als auch operativen Maßnahmen.

Abstract

The cervical spine is often affected in rheumatoid arthritis. Beside destructive changes, instabilities can occur, mainly in the upper cervical spine. Typical symptoms are missing so that routine x-ray examinations are needed to prevent severe consequences up to death. AP/lateral cervical spine x-rax and lateral functional x-rays are the standard diagnostic tool. Depending on the findings, further neurological examination and MRI must be initiated. Aim is the early recognition, respectively prevention of myelopathy. Therapy includes stage dependent conservative and surgical measures.

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Authors and Affiliations

  1. Orthopädische Universitätsklinik Ulm am RKU, Oberer Eselsberg 45, 89081, Ulm, Deutschland

    B. Cakir, W. Käfer & H. Reichel

  2. Klinik für Orthopädie und Unfallchirurgie, Klinik am Eichert,, Göppingen, Deutschland

    R. Schmidt

Authors
  1. B. Cakir
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  2. W. Käfer
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  3. H. Reichel
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  4. R. Schmidt
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Correspondence to B. Cakir.

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Cakir, B., Käfer, W., Reichel, H. et al. Operative Therapie an der Halswirbelsäule bei rheumatoider Arthritis. Orthopäde 37, 1127–1141 (2008). https://doi.org/10.1007/s00132-008-1371-9

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  • DOI: https://doi.org/10.1007/s00132-008-1371-9

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