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Die Wirbelsäule 2018; 02(04): 309-330
DOI: 10.1055/a-0436-4465
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© Georg Thieme Verlag KG Stuttgart · New York

Künstliche Bandscheibe HWS

Matti Scholz
,
Andreas Pingel
,
Christoph-Heinrich Hoffmann
,
Frank Kandziora
Subject Editor: Wissenschaftlich verantwortlich gemäß Zertifizierungsbestimmungen für diesen Beitrag ist Dr. Matti Scholz, Frankfurt/Main.
Further Information

Publication History

Publication Date:
13 November 2018 (online)

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Die zervikale Bandscheibenendoprothetik kann sehr gute Ergebnisse erzielen, wenn präoperativ eine sorgfältige Abklärung erfolgt ist und die richtige Patientenselektion getroffen wird. Dieser Artikel soll als Hilfestellung dienen, die Indikation zur Versorgung mit einer zervikalen Bandscheibenprothese zu stellen, die Implantationstechnik als auch Komplikationsmöglichkeiten erläutern und einen Literaturüberblick über das Outcome nach Versorgung mit einer zervikalen Bandscheibenprothese geben.
Kernaussagen

  • Die Bandscheibenprothetik an der HWS stellt eine Non-Fusionstechnik mit schmalem Indikationsspektrum dar.

  • Als Hauptindikation gilt ein weicher mediolateraler Bandscheibenvorfall mit passender Radikulopathie bei Versagen der konservativen Therapie.

  • Präoperative Abklärung mittels MRT, Röntgen + Röntgenfunktionsaufnahmen und ggf. CT notwendig.

  • Bei Beachtung der Indikationen und Kontraindikationen ist die zervikale Bandscheibenendoprothetik der Fusion mindestens ebenbürtig.

  • Degenerationen im Anschlusssegment können auch durch die Bandscheibenprothesenimplantation nicht verhindert werden.

  • Ein ungelöstes Problem ist das Auftreten von Spontanfusionen (heterotope Ossifikation Grad IV) im Behandlungsverlauf, wobei bisher kein negativer Einfluss auf das klinische Ergebnis nachweisbar war.

  • Die Auswahl der geeigneten Prothesengröße und die sorgfältige Implantationstechnik sind entscheidend für den Behandlungserfolg.

Schlüsselwörter

Bandscheibenvorfall - Stenose - Halswirbelsäule - Bandscheibenprothese - OP-Technik - Outcome - ACD - Komplikationen
 

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