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Die Unfallchirurgie
Erschienen in: Der Unfallchirurg 2/2007

01.02.2007 | CME - Weiterbildung • Zertifizierte Fortbildung

Chirurgisches Management von Wirbelsäulenmetastasen

verfasst von: PD Dr. K.-D. Schaser, I. Melcher, T. Mittlmeier, A. Schulz, J.H. Seemann, N.P. Haas, A.C. Disch

Erschienen in: Die Unfallchirurgie | Ausgabe 2/2007

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Zusammenfassung

Die Wirbelsäule ist die Hauptlokalisation von Skelettmetastasen. Diese sind die häufigsten malignen Läsionen der Wirbelsäule und Anzeichen eines disseminierten Tumorleidens. In Abhängigkeit von primärer Tumorbiologie, Prognose der Überlebenszeit, Vorliegen sensomotorischer Defizite, spinaler Instabilität und Gesamtzustand des Patienten muss eine onkologisch sinnvolle und patientengerechte Wahl des therapeutischen Verfahrens erfolgen. Die Etablierung ventraler und erweiterter dorsaler Zugänge und Resektionen sowie neuer Stabilisierungstechniken hat die Grenze zugunsten eines Wandels von konservativen Methoden zur primär chirurgischen Intervention verschoben. Verschiedene valide, prognostische Scores können als Basis für die Differenzialindikation zu verschiedenen chirurgischen Therapieverfahren herangezogen werden und eine individuelle Entscheidungsfindung erleichtern. Indikationen für chirurgisches Vorgehen bestehen bei einer Überlebensprognose von mindestens 3 Monaten, unbeherrschbaren Schmerzen, Progress spinaler Kompression, neurologischer Befundverschlechterung unter Radiochemotherapie, spinaler Instabilität und notwendiger histologischer Befundsicherung.
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Metadaten
Titel
Chirurgisches Management von Wirbelsäulenmetastasen
verfasst von
PD Dr. K.-D. Schaser
I. Melcher
T. Mittlmeier
A. Schulz
J.H. Seemann
N.P. Haas
A.C. Disch
Publikationsdatum
01.02.2007
Verlag
Springer-Verlag
Erschienen in
Die Unfallchirurgie / Ausgabe 2/2007
Print ISSN: 2731-7021
Elektronische ISSN: 2731-703X
DOI
https://doi.org/10.1007/s00113-007-1232-8

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