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Orthopädie und Unfallchirurgie up2date 2023; 18(01): 61-83
DOI: 10.1055/a-1814-3162
Wirbelsäule

Intraoperative Bildgebung, Navigation und Robotik an der Wirbelsäule

Maxim Privalov
,
Paul Alfred Grützner
,
Sven Vetter
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Die Zahl der Wirbelsäulenoperationen nimmt – nicht zuletzt aufgrund der demografischen Entwicklung und hier insbesondere der steigenden Zahl osteoporotischer Frakturen – stetig zu. Im Beitrag werden Vor- und Nachteile der innovativen Technologien im Vergleich zur konventionellen Wirbelsäulenchirurgie dargestellt. Hierbei stehen die Aspekte der intraoperativen Bildgebung und Navigation sowie deren Anforderung an den OP im Vordergrund.
Kernaussagen

  • Die dorsale Instrumentierung der Wirbelsäule ist bei isolierter Anwendung der 2-D-Bildgebung (Fluoroskopie) anspruchsvoll und geht mit Limitationen in Bezug auf Beurteilung von Reposition und Implantatlage einher.

  • Die Verwendung der intraoperativen 3-D-Bildgebung bei der operativen Versorgung von Wirbelsäulenerkrankungen führt nachgewiesenermaßen zu einer Reduktion der postoperativen Revisionsrate.

  • Durch die 3-D-bildgestützte Navigation in der Wirbelsäulenchirurgie werden die Präzision bei der Implantatplatzierung erhöht und minimalinvasive OP-Techniken ermöglicht.

  • Die intraoperative 3-D-Bildgebung, insbesondere die intraoperative CT, bringt neben den hohen Anschaffungskosten auch besondere Anforderungen an die Baustruktur des OP-Saals und an das gesamte OP-Personal mit sich.

  • Die Robotik in der Wirbelsäulenchirurgie findet in vereinzelten Regionen der Welt Akzeptanz. Ein realer Vorteil der Technik muss noch nachgewiesen werden, um die Kosten der Anschaffung rechtfertigen zu können.

Schlüsselwörter

Wirbelsäulenchirurgie - intraoperative 2-D-Bildgebung - intraoperative 3-D-Bildgebung - 3-D-Navigation - roboterassistierte Chirurgie


Publication History

Article published online:
09 February 2023

© 2023. Thieme. All rights reserved.

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