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Obere Halswirbelsäule

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Tscherne Unfallchirurgie

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Zusammenfassung

Frakturen und Luxationen des kraniozervikalen Übergangs und der oberen HWS betreffen die Wirbelsegmente Co/C1 und C1/C2. Sie sind im klinischen Alltag selten, bedürfen oft einer aufwendigen diagnostischen Abklärung und wurden z. T. erst in den letzten Jahren klar definiert und beschrieben. Ihr Nachweis ist außerdem dadurch erschwert, daß sie häufig im Zusammenhang mit Schädel-Hirn- und/oder Polytraumata auftreten. Schließlich führen begleitende neurologische und vaskuläre Komplikationen überdurchschnittlich häufig zu einem tödlichen Ausgang. So analysierte Bohlman [6] 300 Patienten mit Verletzungen der HWS und fand in 1/3 der Fälle eine falsche Diagnose; 30% der Läsionen betrafen die obere HWS. Atlantookzipitale Dislokationen wurden nur von 0,7% der Patienten und atlantoaxiale Verletzungen nur von 23% überlebt. Alker et al. [2] untersuchten 312 verstorbene Verkehrsunfallopfer röntgenologisch und fanden bei 24,4% Läsionen der HWS! Davon betrafen 93% die Okzipitalkondylen sowie C1 und C2. Adams [1] wies bei 12 von 155 Verkehrsopfern atlantookzipitale Dislokationen mit unterschiedlichen Frakturen des okzipitozervikalen Übergangs nach. Bei weiteren 21 Verstorbenen lagen Verletzungen der Ligg. alaria oder der Membrana tectoria ohne Instabilität der betroffenen Bewegungssegmente vor.

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Authors
  1. M. Blauth
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  1. Medizinische Hochschule Hannover, 30623, Hannover, Germany

    Harald Tscherne (Direktor der Unfallchirurgischen Klinik) (Direktor der Unfallchirurgischen Klinik)

  2. Unfallchirurgischen Klinik, Medizinische Hochschule Hannover, 30623, Hannover, Germany

    Michael Blauth

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© 1998 Springer-Verlag Berlin Heidelberg

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Blauth, M. (1998). Obere Halswirbelsäule. In: Tscherne, H., Blauth, M. (eds) Tscherne Unfallchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58840-2_2

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  • DOI: https://doi.org/10.1007/978-3-642-58840-2_2

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