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Instabilität der Wirbelsäule

Ursachen, Diagnose und Behandlung

Spinal instability

Causes, diagnostics and treatment

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Zusammenfassung

Hintergrund

Die erworbene Instabilität der Wirbelsäule ist eine biomechanische Funktionsstörung, die sich während oder nach der Wachstumsphase herausbildet. Sie ist die Hauptursache von Rückenschmerzen bei Wirbelsäulenerkrankungen im Erwachsenenalter.

Patienten und Methoden

Insgesamt wurden 440 Patienten mit chronischen und subakuten Rückenschmerzen evaluiert, 179 Männer und 261 Frauen im Alter von 16 bis 92 Jahren (Durchschnittsalter der Männer 48 Jahre, der Frauen 53 Jahre). Die durchschnittliche Dauer der Symptomatik betrug 8 Monate. Die Patienten wurden in zwei Gruppen eingeteilt. Gruppe 1 mit 140 Patienten (32%) führte nur 9 Therapiesitzungen durch, Gruppe 2 mit 300 Patienten (68%) absolvierte das ganze Programm, bestehend aus 18 Sitzungen. Die Therapie erfolgte in beiden Gruppen 2-mal wöchentlich.

Ergebnisse

In Gruppe 1 war bei 56 Patienten (40%) keine Verbesserung zu verzeichnen, 84 Patienten (60%) verspürten eine positive Entwicklung. In Gruppe 2 bemerkten 33 Patienten (11%) keine Veränderung; 267 Patienten (89%) verspürten eine signifikante Besserung, sodass bei diesen ein Erhaltungsprogramm mit einem Follow-up von 6 bis 12 Monaten verordnet wurde.

Schlussfolgerung

Die erworbene Instabilität der Wirbelsäule sollte frühzeitig diagnostiziert und entsprechend behandelt werden. Mit 18 Therapiesitzungen 2-mal wöchentlich kann sich die Stabilität optimal entwickeln. Dadurch wird die Wirbelsäule nicht nur vor frühzeitigen Verschleißerscheinungen bewahrt, sondern es lassen sich auch weitere pathologische Risiken vermeiden.

Abstract

Background

Acquired spinal instability is a biomechanical dysfunction and its development during or subsequent to the growth phase plays a major role in the progression of spinal diseases in adults.

Patients and methods

A total of 440 chronic and sub acute low-back pain patients were evaluated. There were 179 males and 261 females ranging in age from 16 to 92 years (mean age male 48 years, female 53 years). The patient population was divided into two groups. (I) the first group consisted of 140 patients (32% of the population) who completed a total of 9 sessions. (II) The second group consisted of the remaining 300 patients (68% of the population) who completed the whole program of 18 therapy sessions. The patients experienced spine symptoms on average for 8 months prior to the first evaluation. The two groups received the improvement of the three-dimensional lumbar spine functionality twice weekly.

Results

In group I a total of 56 patients (40%) experienced no improvement, however, 84 patients (60%) reported a significant improvement. In the second group 33 patients (11%) experienced no changes and 267 patients (89%) reported a significant improvement. For the second subgroup a maintenance program was continued with a further follow-up after 6–12 months.

Conclusions

Acquired spinal instability is a major contributing factor to the development of spinal diseases and it is therefore crucial to diagnose this early and to treat the dysbalance by improving the three-dimensional lumbar spine functionality. Optimal results in spine stabilization are achieved with an intensive program twice weekly for 18 sessions. This will assure that the spine is not only protected from early wear and tear but also from further pathological risks.

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Authors and Affiliations

  1. Dynasom-Rehabilitationszentrum Stadelhofen, Zürich, Schweiz

    A. Mizher, A. Rüegg, P. Walthard & T. Hasler

  2. Dynasom F & E-Institut, Helene-und-Maria-Schieß-Str. 2, 78467, Konstanz, Deutschland

    A. Mizher

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  1. A. Mizher
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  2. A. Rüegg
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  3. P. Walthard
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  4. T. Hasler
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Correspondence to A. Mizher.

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Mizher, A., Rüegg, A., Walthard, P. et al. Instabilität der Wirbelsäule. Manuelle Medizin 50, 211–216 (2012). https://doi.org/10.1007/s00337-012-0934-3

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