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Z Orthop Unfall 2017; 155(03): 288-296
DOI: 10.1055/s-0043-100099
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Gutachtliche Beurteilung des traumatischen Bandscheibenvorfalls

Expert Assessment of Traumatic Disc Herniations
Martin Schwarze
1   Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinikum Heidelberg
,
Marc-André Weber
2   Radiologische Klinik, Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg
,
Florin M. Bucur
1   Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinikum Heidelberg
,
Marcus Schiltenwolf
1   Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinikum Heidelberg
› Author Affiliations
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Publication History

Publication Date:
19 April 2017 (online)

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Zusammenfassung

In einer Vielzahl von Rechtsgebieten soll der Sachverständige die Kausalität von Bandscheibenschäden klären: Ist der Schaden Folge eines Unfalls? Die Literatur nennt spezifische Anforderungen an den Traumamechanismus sowie zeitliche Kriterien, welche die Kausalitätsprüfung vorgeben. Es handelt sich im Wesentlichen um hochenergetische Traumen mit unmittelbar einsetzenden Funktionsstörungen. Unfallnahe MRT-Untersuchungen haben im gutachterlichen Beurteilungsprozess überragende Bedeutung zur Sicherung des Körpererstschadens. Bei der Prüfung des haftungsbegründenden Zusammenhangs müssen konkurrierende Ursachen gewürdigt werden. Da sich die juristischen Anforderungen der Kausalitätsprüfung in Zivil- und Sozialrecht unterscheiden, bedarf es der Kenntnis der Rechtsnormen. Ein Prüfschema wird vorgestellt, das den Begutachtungsprozess über Einstiegs-, Realisierungs- und Entscheidungsebene unterstützt.

Abstract

In numerous legal areas, expert assessments are needed to clarify the causality of herniated discs: Was the damage caused by an accident? The literature mentions specific requirements regarding the trauma mechanism as well as temporal criteria, which prescribe the causality test. These are essentially high-energy traumas with immediate functional impairments. Accident-related MRI examinations are of paramount importance in the expert assessment process to confirm the primary body harm. In examining the causality constituting liability, competitive causes must be assessed. Since the legal requirements of the causality test differ in civil and social law, legal norms need to be taken into account. We present a test scheme that supports the assessment process through entry, implementation and decision-making levels.

Schlüsselwörter

traumatischer Bandscheibenvorfall - Begutachtung - haftungsbegründende Kausalität - Erstkörperschaden - Prüfschema

Key words

assessment - primary body harm - testing scheme - traumatic disc herniation - causality constituting liability
 

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