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Die Wirbelsäule 2019; 03(01): 37-58
DOI: 10.1055/a-0740-3828
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Sagittales Profil der Wirbelsäule: Was ist sinnvoll, was gefährdet den Patienten, was ist Hype ? Pro: Korrektur ist oberste Maxime

Sagittal spinal alignment: Current concepts and a plea for a better appreciation of sagittal balance
Heiko Koller
  Wirbelsäulen- und Skoliosezentrum, Schön Klinik Vogtareuth, Vogtareuth
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
22. Februar 2019 (online)

    Lizenzen und Reprints

Zusammenfassung

Die Notwendigkeit der Rekonstruktion eines physiologischen sagittalen Wirbelsäulenprofils bei Wirbelsäulenoperationen wird regelhaft in Fachdiskussionen kritisch hinterfragt. Die Gründe dafür liegen in der Natur sog. Deformitäteneingriffe, welche eine gesteigerte Komplexizität, operativen Schweregrad und auch Komplikationspotenzial mit sich führen. Der vorliegende Artikel erarbeitet ausführlich die Bedeutung der Rekonstruktion eines spinalen Alignments und einer sagittalen spinalen Balance. Vorteile und potenzielle Schwierigkeiten sowie Herausforderungen werden ausgewogen dargestellt. Die klinische Erfahrung, gestützt von wachsender publizierter Evidenz, bestärkt den Wirbelsäulenchirurgen in seinem Auftrag, auch die spinale sagittale Balance bei Wirbelsäuleneingriffen zu wahren und bei Bedarf auch zu rekonstruieren.

Abstract

The need for surgical reconstruction of a physiologic sagittal spinal alignment during spinal surgery is frequently debated. Reasons are related to the unique characteristics of spinal deformity surgery including high surgical complexity, advanced challenges to both the surgeon and the patient as well as the risk for an increased rate of surgical and medical complications. The presented paper explores the importance of reconstruction of spinal sagittal alignment and rebalance in any kind of spinal surgery and in particular in patients with spinal deformity – both in the adult and pediatric patients. The advantages and the potential drawbacks of spinal deformity surgery are presented in a weighed discussion. Cumulated clinical experience and literature evidence delegates responsibility to any surgeon to protect or to restore sagittal spinal balance in any kind of spinal surgery.

Schlüsselwörter

sagittale Balance - spinale Rekonstruktion - Deformitätenchirurgie - spinale Statik

Keywords

spinal balance - spinal deformity surgery - spinal reconstruction - clinical rationale
 

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