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Die Wirbelsäule 2020; 04(04): 261-267
DOI: 10.1055/a-1169-1902
Übersicht

Bandscheiben-Prothese bei zervikaler Myelopathie

Total Disc Replacement in cervical myelopathy
Christoph Mehren
1   Schön Klinik München Harlaching
2   Akademisches Lehrkrankenhaus Paracelsus Medizinische Universität (PMU) Salzburg
,
Bastian Storzer
1   Schön Klinik München Harlaching
2   Akademisches Lehrkrankenhaus Paracelsus Medizinische Universität (PMU) Salzburg
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Zusammenfassung

Die klinische Diagnose einer zervikalen Myelopathie kann sich aus einer Vielzahl von unterschiedlichen Pathologien an der Halswirbelsäule ergeben. Die sich daraus ableitenden operativen Behandlungsoptionen sind ebenso vielfältig und unterscheiden sich sowohl in Bezug auf die Lokalisation des Zugangs (ventral oder dorsal) als auch in der Philosophie eines stabilisierenden-fusionierenden Verfahrens bzw. eines bewegungserhaltenden Verfahrens. Die zervikale Bandscheibenprothese ist v. a. im Bereich der degenerativen Bandscheibenerkrankungen eine inzwischen anerkannte Operationsmethode mit sehr guten klinischen Ergebnissen auch im Langzeit-Follow-up. Unter Berücksichtigung der Kontraindikationen kann diese auch eine zuverlässige Option bei der operativen Behandlung einer zervikalen Myelopathie darstellen. Jedoch muss klar festgehalten werden, dass das Vorliegen einer Myelopathie in den meisten Fällen auf Pathologien beruht, die eine Non-Fusion-Philosophie nicht zulassen.

Abstract

The clinical diagnosis of cervical myelopathy can result from a variety of different pathologies in the cervical spine. The resulting surgical treatment options are just as diverse and differ both in terms of the location of the access (ventral or dorsal) and in the philosophy of a stabilising/fusing procedure or a movement-preserving procedure. The cervical disc prosthesis is especially in the field of degenerative disc diseases a meanwhile recognized surgical method with very good clinical results also in long-term follow-up. Taking into account the contraindications, it can also be a reliable option in the surgical treatment of cervical myelopathy. However, it must be clearly stated that the presence of a myelopathy is in most cases based on pathologies that do not allow a non-fusion philosophy.

Schlüsselwörter

Bandscheibenprothetik - Myelopathie - zervikale Degeneration - Anschlusssegmentdegeneration - Hybrid

Keywords

Total Disc Replacement - Myelopathy - Cervical Degeneration - Adjacent Segment Disease - Hybrid


Publication History

Article published online:
29 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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