Verletzungen der oberen Halswirbelsäule

Die Häufigkeit, Diagnostik, Klassifikation, die klinische Erstversorgung und die Standardtherapie sowie die Prinzipien der Nachsorge der einzelnen Verletzungen der Halswirbelsäule werden im Rahmen dieses Weiterbildungsartikels dargestellt. Ein konservatives Therapieregime ist vielfach möglich. Bei instabilen bzw. dislozierten Verletzungen bedarf es einer operativen Intervention, wobei verschiedene operative Verfahren zum Einsatz kommen.

Abstract

Around a third of all cervical spine injuries occur in the upper cervical spine in the area between the occiput and the second cervical vertebra. The latter being the most common location of the injury with around 70%. But also atlas fractures, occipital condyle fractures, traumatic spondylolisthesis of C2, atypical fractures in the corpus area as well as atlantooccipital and atlantoaxial ligamentous lesions should be mentioned in connection with injuries in this area. In many cases, conservative therapy regimen is possible. In unstable or displaced injuries, however, surgical intervention is required, with various surgical procedures being used. The frequency, diagnostics, classification, and standard therapy of the individual entities are presented in detail in this continuing medical education article.

Kernaussagen

• Von allen Halswirbelsäulenverletzungen entfällt rund ein Drittel auf die obere Halswirbelsäule im Bereich zwischen Okziput und dem 2. Halswirbelkörper, der mit ca. 70% die häufigste Verletzungslokalisation darstellt.

• Frakturen des Atlas und der Okzipitalkondylen sowie die traumatischen Spondylolisthesen von HWK II, die atypischen Frakturen im Korpusbereich und die atlantookzipitalen und atlantoaxialen ligamentären Läsionen sind im Zusammenhang mit Verletzungen dieses Bereichs zu nennen.

• Grundsätzlich richtet sich die notwendige Diagnostik und klinische Erstversorgung nach den Prinzipien des Advanced Trauma Life Support (ATLS).

• Häufig ist ein konservatives Therapieregime möglich.

• Bei instabilen bzw. dislozierten Verletzungen bedarf es einer operativen Intervention, wobei verschiedene operative Verfahren zum Einsatz kommen.

Schlüsselwörter

Wirbelsäulentrauma - Halswirbelsäule - Halswirbelkörper - atlantookzipitale Dissoziation

Keywords

cervical spine - spine injury - cervical vertebra

Publication History

Article published online:
08 August 2024

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