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rheuma plus

, Volume 17, Issue 4, pp 122–131 | Cite as

Die rheumatische Halswirbelsäule

  • M. Schroeder
  • W. Rüther
  • C. Schaefer
Chirurgie
  • 34 Downloads

Zusammenfassung

Hintergrund

Die Halswirbelsäule ist bei der rheumatoiden Arthritis eine der Hauptmanifestationsorte außerhalb der Extremitäten. Sie kann durch das Auftreten mechanischer Instabilitäten sowie neurologischer Symptome einen entscheidenden Einfluss auf den Krankheitsverlauf nehmen. Sowohl die adäquate Diagnosestellung als auch die entsprechende chirurgische Behandlung stellen eine Herausforderung für behandelnde Ärzte dar.

Material und Methoden

In dieser Übersichtsarbeit werden relevante diagnostische Strategien und chirurgische Interventionsmöglichkeiten vorgestellt, deren Ziel die Vermeidung potenziell fataler neurologischer Symptome ist. Darüber hinaus werden Grundlagenarbeiten und Expertenmeinungen diskutiert.

Ergebnisse und Diskussion

Durch ein zeitgerechtes chirurgisches Vorgehen sowie engmaschige klinische und radiologische Kontrollen unter konservativer und nach chirurgischer Therapie lassen sich für Patienten potenziell fatale Verläufe vermeiden.

Schlüsselwörter

Atlantoaxiales Gelenk Gelenkinstabilität Myelopathie Spondylodese Basiläre Impression 

The rheumatic cervical spine

Abstract

Background

The cervical spine is one of the main sites of manifestation in rheumatoid arthritis outside of the extremities. It can have a decisive influence on disease course via the occurrence of mechanical instabilities as well as neurologic symptoms. Both adequate diagnosis and the corresponding surgical treatment represent a challenge for the involved physicians.

Materials and methods

This review presents relevant diagnostic strategies and possibilities for surgical intervention which aim to avoid potentially fatal neurologic symptoms. Basic literature and expert opinions are also discussed.

Results and conclusion

Through target-oriented surgical management, as well as tight clinical and radiologic monitoring during conservative and surgical therapy, potentially fatal disease courses can be avoided.

Keywords

Atlanto-axial joint Joint instability Myelopathy Spondylodesis Basilar impression 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Schroeder, W. Rüther und C. Schaefer geben an, dass kein Interessenkonflikt besteht.

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

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Copyright information

© Springer-Verlag GmbH Austria, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für WirbelsäulenchirurgieOrthopädische Universitätsklinik am Klinikum Bad BramstedtBad BramstedtDeutschland
  2. 2.Klinik und Poliklinik für OrthopädieUniversitätsklinikum Hamburg-EppendorfHamburgDeutschland

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