Zusammenfassung
Infolge der mittlerweile jahrzehntelangen Erfahrung mit operativen Eingriffen an der Halswirbelsäule sind die statistischen Risiken für schwere Komplikationen durch eine Operation signifikant gesunken. Dennoch müssen diese im Rahmen eines Aufklärungsgesprächs dem Patienten erörtert und im Aufklärungsbogen schriftlich fixiert werden. Insgesamt liegen die Risiken für schwere Komplikationen (Verletzung von Myelon, Nervenwurzeln, Gefäßen sowie Luft- und Speiseröhre) im unteren einstelligen Prozentbereich bzw. teils unter 1 %. Die Prognose für eine Rückbildung eines Radikulärsyndroms nach operativer Dekompression ist sehr gut. Ebenso werden mittlerweile bei der zervikalen Myelopathie gute und sehr gute Ergebnisse nach operativer Dekompression erzielt.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatur
Belanger TA, Roh JS, Hanks SE et al. (2005) Ossification of the posterior longitudinal ligament. Results of anterior cervical decompression and arthrodesis in sixty-one North American patients. J Bone Joint Surg Am 87:610–615
Bilbao G, Duart M, Aurrecoechea JJ et al. (2010) Surgical results and complications in a series of 71 consecutive cervical spondylotic corpectomies. Acta Neurochir (Wien) 152:1155–1163
Chiba K, Toyama Y, Matsumoto M et al. (2002) Segmental motor paralysis after expansive open-door laminoplasty. Spine 27:2108–2115
Choi S, Lee SH, Lee JY et al. (2005) Factors affecting prognosis of patients who underwent corpectomy and fusion for treatment of cervical ossification of the posterior longitudinal ligament: analysis of 47 patients. J Spinal Disord Tech 18:309–314
Eleraky MA, Llanos C, Sonntag VK (1999) Cervical corpectomy: report of 185 cases and review of the literature. J Neurosurg 90:(1 Suppl) 35–41
Epstein N (1993) The surgical management of ossification of the posterior longitudinal ligament in 51 patients. J Spinal Disord 6:432–455
Epstein NE (1998) Circumferential surgery for the management of cervical ossification of the posterior longitudinal ligament. J Spinal Disord 11:200–207
Fehlings MG, Smith JS, Kopjar B et al. (2012) Perioperative and delayed complications associated with the surgical treatment of cervical spondylotic myelopathy based on 302 patients from the AOSpine North America Cervical Spondylotic Myelopathy Study. J Neurosurg Spine 16(5):425–432
Heller JG, Silcox DH III, Sutterlin CE III (1995) Complications of posterior cervical plating. Spine 20:2442–2448
Kato Y, Iwasaki M, Fuji T et al. (1998) Long-term follow-up results of laminectomy for cervical myelopathy caused by ossification of the posterior longitudinal ligament. J Neurosurg 89:217–223
Lunardi DJ, Eskander MS, Even JL et al. (2013) Vertebral artery injuries in cervical spine surgery. Spine J S1529-9430(13)01556–8
Machino M, Yukawa Y, Hida T et al. (2012) The prevalence of pre- and postoperative symptoms in patients with cervical spondylotic myelopathy treated by cervical laminoplasty. Spine (Phila Pa 1976) 15;37(22):E1383–1388
Sakaura H, Hosono N, Mukai Y et al. (2003) C5 palsy after decompression surgery for cervical myelopathy: review of the literature. Spine 28:2447–2451
Saunders RL, Pikus HJ, Ball P (1998): Four-level cervical corpectomy. Spine 23:2455–2461
Smith ZA, Buchanan CC, Raphael D, Khoo LT (2011) Ossification of the Posterior Longitudinal Ligament. Pathogenesis, Management, and Current Surgical Approaches: A Review. Neurosurg Focus 30(3):E10
Swank ML, Lowery GL, Bhat AL, McDonough RF (1997) Anterior cervical allograft arthrodesis and instrumentation: multilevel interbody grafting or strut graft reconstruction. Eur Spine J 6:138–143
Tsuzuki N, Abe R, Saiki K, Okai K (1993) Paralysis of the arm after posterior decompression of the cervical spinal cord. II. Analyses of clinical findings. Eur Spine J 2:197–202
Vaccaro AR, Falatyn SP, Scuderi GJ et al. (1998) Early failure of long segment anterior cervical plate fixation. J Spinal Disord 11:410–415
Yonenobu K, Hosono N, Iwasaki M et al. (1991) Neurologic complications of surgery for cervical compression myelopathy. Spine 16:1277–1282
Zhu B, Xu Y, Liu X, Liu Z, Dang G (2013) Anterior approach versus posterior approach for the treatment of multilevel cervical spondylotic myelopathy: a systemic review and meta-analysis. Eur Spine J 22(7):1583–1589
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
König, S., Spetzger, U. (2014). Beratung und Aufklärung des Patienten. In: Degenerative Erkrankungen der Halswirbelsäule. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43562-5_9
Download citation
DOI: https://doi.org/10.1007/978-3-662-43562-5_9
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-43561-8
Online ISBN: 978-3-662-43562-5
eBook Packages: Medicine (German Language)