Techniken der spinopelvinen Fixation bei Erwachsenen

 

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Zusammenfassung

Mit der Entwicklung der Wirbelsäulenchirurgie werden Patienten in zunehmendem Maße mit Stabilisierungs- oder Fusionsverfahren versorgt, wobei die fusionierten Segmente häufig auch das Sakrum umfassen. Eine stabile Fusion des lumbosakralen Übergangs ist allerdings schwierig zu erhalten. Einer der Lösungen dieses Problems ist die Verankerung der Fixation im Becken, bzw. im Os ilium. Nach der ursprünglichen Methode der Iliumschraubenimplantation mit Eintrittspunkt an der Spina iliaca posterior superior wurden weitere Techniken und Trajektorien beschrieben, die verschiedene Vor- und Nachteile aufweisen. Trotz der laufenden technischen Weiterentwicklung ist die Implantationstechnik mittlerweile prinzipiell ausgereift, mit niedrigem Komplikationsprofil und wichtigen biomechanischen Vorteilen, sodass mit der Implantation bei längeren Spondylodesen nicht gezögert werden soll.

Abstract

With the development of the spine surgery, an increasing number of patients are treated using spinal fusion techniques. Often, the fusion includes the sacrum. However, it is difficult to obtain a stable permanent fixation/fusion of the lumbosacral segment. One of the solutions is the fixation to the pelvis, more precisely, to the ilium. After the initial technique of iliac screw implantation with entry point at the posterior superior iliac spine, other methods of spinopelvic fixation have been developed, with specific advantages and disadvantages. Although new implantation methods are still being developed, the implantation techniques can be considered technically mature. They offer important biomechanical advantages and show low complication rates. Therefore, the use of iliac fixation should not be omitted in long fixation constructs.

Publication History

Article published online:
23 August 2021

© 2021. Thieme. All rights reserved.

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