Effektivität konservativer Behandlungsstrategien bei zervikaler Stenose - Pathophysiologie, klinische Präsentation und Evidenz für konservative Behandlung

Zusammenfassung

Das Ziel dieses Literaturreviews bestand darin, die Evidenz für die konservative Behandlung bei zervikaler Spinalstenose zu untersuchen und einen kurzen Überblick über Pathogenese und klinische Präsentation zu geben. Da die Studien, die die Effektivität von Chirurgie und Physiotherapie verglichen, verschiedene Behandlungsmodalitäten anwendeten oder gar nicht nannten, lassen sich keine Schlussfolgerungen über die Effektivität der untersuchten Strategien ziehen.

Physiotherapeuten müssen daher eine umfassende und gründliche subjektive und objektive Untersuchung durchführen, um die Ursache der Symptome aufzuspüren und die angemessene Behandlung zu verabreichen. Dabei werden sie von einem in die patientenzentrierte Behandlung integrierten kontinuierlichen Prozess des Clinical Reasoning geleitet.

Insgesamt besteht eine allgemeine Übereinstimmung darüber, dass bei leichten bis moderaten Krankheitspräsentationen eine konservative Behandlung indiziert ist. Zukünftige Studien sollten jedoch mehr Nachdruck auf die unterschiedlichen konservativen Behandlungsmodalitäten legen, um die Effektivität derselben noch genauer zu beleuchten.

Abstract

The aim of this literature review was to investigate the evidence for conservative treatment in cervical spinal stenosis and to give a short overview on the pathogenesis and clinical presentation. As studies comparing the effectiveness of surgery and physiotherapy applied different treatment modalities or did not mention them at all it is not possible to draw any conclusion about the effectiveness of the investigated strategies.

Physiotherapists have to carry out a comprehensive and systematic examination in order to detect the source of symptoms and to apply the adequate treatment. In this process they are guided by a continuous clinical reasoning process integrating a patient-centred overall management.

Overall there is general agreement that in mild to moderate presentations of the disease, conservative treatment is indicated. However, future studies should put more emphasis on different conservative treatment modalities in order to get a better sort of idea about the efficiency of these modalities.

Schlüsselwörter

zervikale Stenose - zervikale Spondylose - zervikale spondylotische Myelopathie - zervikale spondylotische Radikulopathie - konservative Behandlung

Key words

cervical stenosis - cervical spondylosis - cervical spondylotic myelopathy - cervical spondylotic radiculopathy - conservative management

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