Stoltze D, Harms J
Abteilung Orthopädische Traumatologie I, Wirbelsäulenchirurgie und Paraplegiologie, Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany.
Orthopade. 1999 Aug;28(8):731-745. doi: 10.1007/PL00003661.
The reason for inadequate results after the treatment of spinal lesions may be due to the misinterpretation of the type of lesion thus leading to incorrect therapy. Frequently the biofunctional construction principles of the spine are ignored and biomechanically based reconstruction of the spine is not done. Unsuitable approaches and fusion techniques may result in insufficient stabilisation with predictable failure. In both the first surgery and the salvage procedure, the principles of the load-sharing system as well as the posterior tension band principle must be respected. These principles and the surgery techniques are demonstrated in individual examples. Special attention is drawn to the impact of segmental deformities on the general statics of the spine. Frequently, residual deformities with the typical clinical picture lead to decompensation and the reduction of efficiency only after ten to fifteen years.
脊柱病变治疗后效果不佳的原因可能是对病变类型的错误解读，从而导致治疗不当。脊柱的生物功能构建原则常常被忽视，基于生物力学的脊柱重建也未进行。不合适的手术入路和融合技术可能导致固定不足，进而出现可预见的失败。在初次手术和挽救手术中，都必须遵循负荷分担系统原则以及后张力带原则。这些原则和手术技术将在个别实例中展示。特别要注意节段性畸形对脊柱整体静力学的影响。通常，具有典型临床表现的残留畸形仅在十至十五年后才会导致失代偿和功能效率降低。
