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Verletzungen des kraniozervikalen Übergangs

Injuries to the craniocervical junction

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Zusammenfassung

Die Verletzungen der oberen Halswirbelsäule (HWS) von C0–C2 spielen bei der operativen Behandlung der Traumafolgen der gesamten HWS eine besondere Rolle. Obgleich die Zahl derartiger Versorgungen in den letzten Jahren zugenommen hat, liegen klare Behandlungsempfehlungen für die meisten Verletzungsformen nicht vor. Da das Spektrum der in Frage kommenden Verletzungen breit und die Zahl der Behandlungsalternativen entsprechend groß ist, wird für diese Übersichtsarbeit besonders auf folgende Verletzungen eingegangen: C0-Fakturen [Frakturen der Hinterhauptkondylen (OKF)], atlantookzipitale Dislokationen (AOD), Atlasfrakturen, atlantoaxiale Instabilitäten (AAD) und Axisfrakturen.

Es werden besondere Aspekte des Unfallmechanismus, der klinischen Symptomatik, sowie diagnostische Abläufe und Behandlungsoptionen erläutert. Hierbei wird besonders auf die Darstellung alternativer Behandlungsmethoden im Literaturvergleich Wert gelegt. Eine zusammenfassende Tabelle am Ende eines jeden Kapitels erleichtert die schnelle Orientierung.

Abstract

Injuries to the upper cervical spine (C0–C2) play a major role in surgical treatment of traumatic sequelae in the entire cervical spine. Even though the number of such operations has increased in recent years, there are no clear treatment recommendations for most types of cervical spine injuries. In view of the wide range of injury types and the correspondingly large number of treatment options, this review focuses mainly on the following types of injuries: C0 fractures, occipital condyle fractures (OCF), atlanto-occipital dislocation (AOD), atlas fractures, atlantoaxial dislocation (AAD), and axis fractures.

Important aspects of the mechanisms of injury, clinical signs and symptoms, diagnostic procedures, and treatment options are discussed. Special emphasis is placed on comparatively reviewing the different treatment options discussed in the literature. A summary in table form is presented at the end of each chapter for quick reference.

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Kayser, R., Weber, U. & Heyde, C.E. Verletzungen des kraniozervikalen Übergangs. Orthopäde 35, 244–269 (2006). https://doi.org/10.1007/s00132-005-0920-8

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