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Intensivmedizin up2date 2015; 11(01): 77-92
DOI: 10.1055/s-0034-1390907
Neuro-Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Chirurgische und konservative Therapie traumatischer Rückenmarkverletzungen

Klaus Zweckberger
,
Alexander Younsi
,
Andreas W. Unterberg
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Publication History

Publication Date:
08 January 2015 (online)

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Kernaussagen

  • Die traumatische Rückenmarkschädigung führt zu einer inkompletten oder kompletten Para- oder Tetraparese mit einer erheblichen Einschränkung der Lebensqualität und hohen sozioökonomischen Kosten.

  • Hauptrisikofaktoren für das Überleben sind das Alter, die Höhe der Rückenmarkschädigung, das Ausmaß neurologischer Defizite und pulmonale Infektionen.

  • Zur Erstversorgung gehören die Sicherung der Vitalfunktionen am Unfallort (ggf. Intubation) und eine Immobilisierung (Stiff-neck, Vakuummatratze).

  • Bei einer Kompression des Rückenmarks oder einer instabilen Fraktur ist eine Entlastung des Rückenmarks mit zusätzlicher Stabilisierung innerhalb von 24 Stunden erforderlich.

  • Besonders respiratorische und kardiovaskuläre Komplikationen, Thrombembolien und ein gestörter Metabolismus sowie Infektionen sind eine Herausforderung in der weiteren intensivmedizinischen Behandlung.

  • Besonders bei jungen Patienten mit inkompletter Querschnittslähmung kann die Rehabilitationsbehandlung funktionelle Erfolge erreichen.

Die Literatur zu diesem Beitrag finden Sie unter http://dx.doi.org/10.1055/s-0034-1390907.

 

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