Neurochirurgisch relevante Krankheitsbilder bei Skoliose – Diagnostik und Therapie im interdisziplinären Kontext

Zusammenfassung

Die kindliche Skoliose ist eine der häufigsten Erkrankungen des Bewegungsapparates, die mit einer seitlichen Verkrümmung der Wirbelsäule und einer begleitenden Rotation der Wirbelkörper einhergeht. Die Prävalenz idiopathischer Skoliosen variiert weltweit, doch ist die Notwendigkeit einer frühzeitigen Diagnosestellung und adäquaten Therapie unerlässlich. Besonders herausfordernd wird die Behandlung, wenn eine sekundäre Skoliose aufgrund von neurologischen oder strukturellen Anomalien vorliegt. Die Ätiologie der Skoliose ist vielfältig, wobei idiopathische Formen den größten Anteil ausmachen. Weniger häufig treten jedoch auch sekundäre Skoliosen auf, die durch neurologische Störungen, kongenitale Fehlbildungen oder neurodegenerative Erkrankungen bedingt sind. Die Diagnostik und Therapie dieser sekundären Formen der Skoliose stellen nicht nur die Orthopäden, sondern auch Neurochirurgen vor große Herausforderungen. Daher erfordert die Behandlung ein hohes Maß an interdisziplinärer Zusammenarbeit. In diesem Artikel werden drei interdisziplinär relevante Krankheitsbilder beschrieben, die eine Skoliose bedingen, koinzident auftreten und ihren Verlauf beeinflussen können und bei ihrer Therapie berücksichtigt werden müssen: die Chiari-I-Malformation (CM), die Diastematomyelie (DM) und das Tethered Cord-Syndrom (TC). Zu jedem Krankheitsbild wird der neurologische Zusammenhang zur Skoliose erläutert und sowohl diagnostische als auch therapeutische Maßnahmen anhand aktueller Literatur vorgestellt. Die Bedeutung des interdisziplinären Ansatzes zwischen Orthopädie und Neurochirurgie steht dabei Im Fokus.

Abstract

Scoliosis in infants and youth is one of the most common diseases of the musculosceletoal system, commonly defined by a curvature and rotation of vertebrae. While its prevalence may differ globally, the necessity for adequate diagnostic and care is uniform. The concurrence with anamolies of neuronal structures may pose an additional challenge. The etiology of scoliosis is variable, while idiopathic forms comprise the larger part. Rarer are secondary scolioses, deriving from neurological disorders, congenital anomalies or neurodegenerative disease. Diagnostic and therapy in these cases challenges neurosurgeons and orthopedic surgeons alike. An interdisciplinary approach is crucial. In this article, we feature three cases with interdisciplinary relevance, in which disorders of the neuronal system led to scoliosis and need special attention in treatment: Chiari type 1 malformation (CM), split cord syndrom or diastematomyelia (DM) and the tethered-cord syndrome (TC). For each disorder, we elucidate ist link to scoliosis and elaborate on diagnostic and therapeutic implications in current literature. We focus on the intersection in-between orthopedic and neurosurgical approaches.

Schlüsselwörter

Skoliose - Chiari-Malformation - Spina bifida - Diastematomyelie

Keywords

scoliosis - chiari type 1 malformation - spinal dysraphism - split cord syndrome

Publication History

Article published online:
02 October 2025

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