Gegenwärtiger Stand der operativen Behandlung der instabilen Wirbelsäule unter besonderer Berücksichtigung neurochirurgischer Indikationen

Abstract

The presently available surgical techniques will practically always allow stabilization of the vertebral column in case of injuries indicating the need for surgery. Patients can be subjected to early functional treatment and introduced to rehabilitation training without requiring the plaster casts that used to be major obstacles to mobilization. Excellent results can be obtained in injuries of the thoracic and lumbar vertebral column if surgery is performed early, using less invasive dorsal stabilization techniques. Dorsal intervention is also possible in polytraumatic and intensive-care patients whose overall condition prohibits a ventral approach because of the stress involved in such surgery. During a period of just five years traumatologic surgery of the vertebral column has advanced by leaps and bounds, while proving that in surgery of the vertebral column close cooperation of neurosurgeons and surgeons is mandatory because of the hazards involved with particular regard to neural structures. In this manner a safety factor is created from which the patient benefits because such experience is a prerequisite for achieving good overall results. Surgery of the vertebral column is not just general surgery; in fact, it usually involves a large number of personnel and technical equipment such as only well-staffed and well-equipped institutions have at their disposal, but the results achieved at Kiel university have shown that zeal and purposefulness enable the successful management even of technically complicated interventions.