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Lumbale Spondylodese – Indikationen und Techniken

Lumbar fusion—Indications and techniques

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Zusammenfassung

Hintergrund

Die lumbale Spondylodese stellt ein etabliertes Operationsverfahren in der Wirbelsäulenchirurgie dar. Die Indikationen sind alle Arten von Instabilitäten des betroffenen Bewegungssegmentes. Ziel der Operation ist eine biomechanisch dauerhafte Fusion der Wirbel, welche durch verschiedene Zugangswege, Implantate und Fusionsmaterialen erreicht werden kann.

Techniken

Hauptsächlich verwendete Techniken sind die posteriore lumbale Fusion (PLF), die posteriore lumbale interkorporelle Fusion (PLIF), die transforaminale lumbale interkoporelle Fusion (TLIF), die anteriore lumbale interkorporelle Fusion (ALIF), die oblique lumbale interkorporelle Fusion (OLIF) und die extrem laterale interkorporelle Fusion (XLIF). Die Techniken sowie deren Indikationen, Komplikationen und Ergebnisse werden in dieser Übersicht beschrieben.

Abstract

Background

Lumbar spinal fusion is an established surgical technique in spine surgery. The goal of spinal fusion is a biomechanically lasting interbody union, which can be accomplished through different surgical approaches, implants and grafts.

Techniques

The mainly surgical techniques used are: posterior lumbar fusion (PLF), posterior interbody lumbar fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), oblique lumbar interbody fusion (OLIF) and extreme lateral interbody fusion (XLIF). These procedures, their indications, complications and results are described in this narrative review.

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Abbreviations

ALIF:

Anteriore lumbale interkorporelle Fusion

BMP :

„Bone morphogenetic proteins“

BV :

Bildverstärker

DBM :

Demineralisierte Knochenmatrix

DLIF :

„Direct lateral interbody fusion“

EMG :

Elektromyographie

LLIF :

„Lateral lumbar interbody fusion“

LWK :

Lendenwirbelkörper

LWS :

Lendenwirbelsäule

OLIF :

Oblique lumbale interkorporelle Fusion

OPS :

Operationen- und Prozedurenschlüssel

PEEK :

Polyetheretherketon

PLF :

Posteriore lumbale Fusion

PLIF :

Posteriore lumbale interkorporelle Fusion

rhBMP :

Rekombinantes humanes BMP

TLIF :

Transforaminale lumbale interkoporelle Fusion

XLIF :

Extrem laterale interkorporelle Fusion

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Authors and Affiliations

  1. Zentrum für Wirbelsäulen- und Skoliosetherapie, Schön Klinik Nürnberg Fürth, Europa-Allee 1, 90763, Fürth, Deutschland

    K. J. Schnake, D. Rappert, S. Schreyer & F. Hilber

  2. Wirbelsäulenzentrum, Schön Klinik München Harlaching, Harlachinger Str. 51, 81547, München, Deutschland

    B. Storzer & C. Mehren

  3. Akademisches Lehrkrankenhaus Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Österreich

    B. Storzer & C. Mehren

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  1. K. J. Schnake
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  2. D. Rappert
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Correspondence to K. J. Schnake.

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K. J. Schnake, D. Rappert, B. Storzer, S. Schreyer, F. Hilber und C. Mehren geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Schnake, K.J., Rappert, D., Storzer, B. et al. Lumbale Spondylodese – Indikationen und Techniken. Orthopäde 48, 50–58 (2019). https://doi.org/10.1007/s00132-018-03670-w

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