Heuer Annika, Koepke Leon-Gordian, Viezens Lennart, Schroeder Malte
Klinik und Poliklinik für Unfallchirurgie und Orthopädie, Sektion Wirbelsäulenchirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
Unfallchirurgie (Heidelb). 2023 Oct;126(10):749-755. doi: 10.1007/s00113-023-01342-9. Epub 2023 Jun 12.
This article describes the current status of modern treatment options for traumatic spinal cord injuries with a particular focus on the perioperative phase. Along with a recognition of age-related specific features that can impact successful treatment of spinal injuries, prompt interdisciplinary treatment while adhering to the "time is spine" principle is of high importance. By considering this approach and using modern diagnostic and surgical techniques, successful surgical treatment can be achieved while taking into account individual characteristics, such as reduced bone quality, accompanying injuries as well as oncological and inflammatory rheumatic comorbidities. The preventive and treatment strategies for frequently occurring complications in the management of traumatic spinal cord injuries are presented. By considering case-specific factors, utilizing modern surgical techniques, avoiding or promptly treating typical complications and initiating interdisciplinary treatment, crucial groundwork for a successful long-term treatment of this highly debilitating and life-altering injury can be established in the perioperative phase.
本文介绍了创伤性脊髓损伤现代治疗方案的现状，特别关注围手术期。认识到可能影响脊柱损伤成功治疗的与年龄相关的特定特征，同时遵循“时间就是脊柱”原则及时进行多学科治疗至关重要。通过采用这种方法并运用现代诊断和手术技术，在考虑个体特征（如骨质减少、伴随损伤以及肿瘤和炎性风湿性合并症）的情况下，可以实现成功的手术治疗。本文还介绍了创伤性脊髓损伤管理中常见并发症的预防和治疗策略。通过考虑具体病例因素、运用现代手术技术、避免或及时治疗典型并发症并启动多学科治疗，可以在围手术期为这种极具致残性和改变生活的损伤的成功长期治疗奠定关键基础。
