Enger Spinalkanal und osteoligamentäre Verletzung der Halswirbelsäule – Synthese

Zusammenfassung

Patienten mit Spinalkanalstenose und osteoligamentärer Verletzung stellen ein sehr heterogenes Kollektiv dar. Neurologisches Defizit, Ausmaß und Lokalisation der Stenose wie auch des Myelonschadens variieren ebenso wie das Ausmaß und die Lokalisation der osteoligamentären Verletzung. Einheitliche Therapierichtlinien, insbesondere zur Operationsindikation, liegen daher nicht vor. Einigkeit besteht darin, dass instabile Wirbelsäulenverletzungen in stabile operativ überführt werden. Bei Vorliegen einer stabilen Verletzung sind patientenspezifische Faktoren für die Wahl der Therapie entscheidend, da die Studienlage nach wie vor kein ausreichendes Evidenzniveau ergibt.

Abstract

Patients with osteoligamentous injuries of the cervical spine with preexisting spinal canal stenosis form a heterogenous group. Neurological deficits, extent and localization of canal stenosis as well as the spinal cord are variable. Uniform standards of therapy, especially with regard to surgical intervention, do not exist. There is unity, that the unstable spine should be surgically converted into a stable one. In stable trauma, patient-specific factors are paramount for the decision, which therapy should be used, as the present studies do not reach a satisfactory level of evidence.

Schlüsselwörter

zervikale Spinalkanalstenose - Rückenmarksverletzung - neurologisches Defizit - osteoligamentäre Verletzung - Evidenz

Keywords

cervical stenosis - spinal cord injury - neurological deficit - osteoligemantous trauma - evidence

Publication History

Article published online:
07 February 2024

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