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Tumoren und Metastasen der oberen Halswirbelsäule (C0–2)

Eine besondere Herausforderung

Tumors and metastases of the upper cervical spine (C0-2)

A special challenge

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Zusammenfassung

Neoplasien der oberen Halswirbelsäule (HWS) sind sehr selten, sie stellen weniger als 0,5 % aller Wirbelsäulentumoren dar. Die Tumorentitäten und ihre Ausprägung sind ebenso mannigfaltig wie ihre Behandlungsmöglichkeiten. Aufgrund der einzigartigen Anatomie der oberen Halswirbelsäule mit ihrem hohen physiologischen Bewegungsumfang spielen biomechanische Überlegungen und die Zusammenhänge mit den angrenzenden Strukturen (A. vertebralis, Medulla oblongata, untere Hirnnerven, Pharynx usw.) ein besonders wichtige Rolle bei der Erstellung des Behandlungsplans. Je nach Tumorart muss das Gleichgewicht zwischen vollständiger Tumorresektion, Erhalt und Wiederherstellung der Stabilität und Funktion sowie Gewährleistung einer etwaigen postoperativen Radiotherapie individuell bestimmt werden. In der folgenden Übersicht werden wichtige Punkte zur Vorbereitung des Patienten, Operationsplanung und chirurgischen Vorgehensweise bei Tumoren des kraniozervikalen Übergangs diskutiert.

Abstract

Tumors of the upper cervical spine are rare and represent less than 0.5 % of all spinal tumors. The types of tumor and the clinical presentation are as varied as the modalities used for treatment. The unique anatomy of the upper cervical spine with its high physical mobility means that biomechanical considerations and neighboring anatomical structures (e.g. vertebral artery, medulla oblongata, lower cranial nerves and pharynx) must be considered when creating a treatment plan. Finding a balance between complete tumor removal, the preservation and reestablishment of stability and function and the possible necessity for postoperative radiotherapy is of utmost importance and must be assessed on an individual basis. In this review paper some important points will be presented concerning the preparation of the patient, the planning of the operation and the surgical approach used in treating tumors of the craniocervical junction.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. D. Jeszenszky, D. Haschtmann, O. Pröbstl, F.S. Kleinstück, C.E. Heyde, T.F. Fekete geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Wirbelsäulenchirurgie, Muskulo-Skelettal-Zentrum, Schulthess Klinik, Lengghalde 2, 8008, Zürich, Schweiz

    D.J. Jeszenszky, D. Haschtmann, O. Pröbstl, F.S. Kleinstück & T.F. Fekete

  2. Orthopädische Klinik und Poliklinik, Universität Leipzig, Leipzig, Deutschland

    C.E. Heyde

Authors
  1. D.J. Jeszenszky
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  2. D. Haschtmann
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  3. O. Pröbstl
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  4. F.S. Kleinstück
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  5. C.E. Heyde
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  6. T.F. Fekete
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Correspondence to D.J. Jeszenszky.

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Jeszenszky, D., Haschtmann, D., Pröbstl, O. et al. Tumoren und Metastasen der oberen Halswirbelsäule (C0–2). Orthopäde 42, 746–754 (2013). https://doi.org/10.1007/s00132-013-2069-1

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