Download PDF
Orthopädie und Unfallchirurgie up2date 2013; 8(2): 127-150
DOI: 10.1055/s-0032-1325010
Wirbelsäule
Georg Thieme Verlag KG Stuttgart · New York

Verletzungen und Erkrankungen der oberen HWS (C0–C2)

Teil 1: Verletzungen der oberen HWS
J. Madert
1   Asklepios Klinik St. Georg, Hamburg
,
K.-H. Frosch
1   Asklepios Klinik St. Georg, Hamburg
,
T. Niemeyer
1   Asklepios Klinik St. Georg, Hamburg
› Author Affiliations
Further Information

Publication History

Publication Date:
25 April 2013 (online)

Also available at
    Permissions and Reprints All articles of this category

Verletzungen der Halswirbelsäule sind selten, die der oberen Halswirbelsäule sehr selten, dafür umso spektakulärer, denn es handelt sich von „Kopf abgerissen“ (okzipitozervikale Luxation) über „Genickbruch“ (Densfraktur) bis hin zur „Henkerfraktur“ (Hangmanʼs Fracture).

Ursächlich für das Spektakuläre ist auch ihr Vorkommen häufig im Rahmen von massiver Gewalteinleitung und der schwierigen Diagnostik aufgrund von Überlagerungen. So finden sich beim Polytrauma 12 % übersehene muskuloskelettale Verletzungen, wobei die Halswirbelsäule wegen nicht vollständiger Diagnostik an erster Stelle steht [25].

 

  • Literatur

  • 1 Anderson LD, DʼAlonzo RT. Fractures of the odontoid process of the axis. J Bone Joint Surg Am 1974; 56 (8) 1663-1674
    PubMedGoogle Scholar
  • 2 Anderson PA, Montesano PX. Morphology and treatment of occipital condyle fractures. Spine (Phila Pa 1976) 1988; 13 (7) 731-736
    CrossrefPubMedGoogle Scholar
  • 3 Antinnes JA, Dvorák J, Hayek J, Panjabi MM, Grob D. The value of functional computed tomography in the evaluation of soft-tissue injury in the upper cervical spine. Eur Spine J 1994; 3 (2) 98-101
    CrossrefPubMedGoogle Scholar
  • 4 Apfelbaum RI, Lonser RR, Veres R, Casey A. Direct anterior screw fixation for recent and remote odontoid fractures. J Neurosurg 2000; 93 (2 Suppl) 227-236
    CrossrefPubMedGoogle Scholar
  • 5 Arand M, Lemke M, Kinzl L, Hartwig E. Incidence of complications of the screw osteosynthesis of odontoid process fractures. Zentralbl Chir 2001; 126 (8) 610-615
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Aryan HE, Newman CB, Nottmeier EW, Acosta jr. FL, Wang VY, Ames CP. Stabilization of the atlantoaxial complex via C-1 lateral mass and C-2 pedicle screw fixation in a multicenter clinical experience in 102 patients: modification of the Harms and Goel techniques. J Neurosurg Spine 2008; 8 (3) 222-229
    CrossrefPubMedGoogle Scholar
  • 7 Dailey AT, Hart D, Finn MA, Schmidt MH, Apfelbaum RI. Anterior fixation of odontoid fractures in an elderly population. J Neurosurg Spine 2010; 12 (1) 1-8
    CrossrefPubMedGoogle Scholar
  • 8 De la Caffinière JY, Seringe R, Roy-Camille R, Saillant G. Physio-pathological study of severe ligament lesions in injuries of the spino-occipital joint. Rev Chir Orthop Reparatrice Appar Mot 1972; 58 (1) 11-19
    PubMedGoogle Scholar
  • 9 Effendi B, Roy D, Cornish B, Dussault RG, Laurin CA. Fractures of the ring of the axis. A classification based on the analysis of 131 cases. J Bone Joint Surg Br 1981; 63-B (3) 319-327
    PubMedGoogle Scholar
  • 10 Fountas KN, Machinis TG, Kapsalaki EZ, Dimopoulos VG, Feltes CH, Liipfert R, Johnston KW, Smisson HF, Robinson JS. Surgical treatment of acute type II and rostral type III odontoid fractures managed by anterior screw fixation. South Med J 2005; 98 (9) 896-901
    PubMedGoogle Scholar
  • 11 Gehweiler JA, Osborne RH, Becker RF. The Radiology of Vertebral Trauma. Philadelphia: Saunders; 1983
    Google Scholar
  • 12 Gelalis ID, Paschos NK, Pakos EE, Politis AN, Arnaoutoglou CM, Karageorgos AC, Ploumis A, Xenakis TA. Accuracy of pedicle screw placement: a systematic review of prospective in vivo studies comparing free hand, fluoroscopy guidance and navigation techniques. Eur Spine J 2012; 21 (2) 247-255
    CrossrefPubMedGoogle Scholar
  • 13 Harms J, Melcher RP. Posterior C1–C2 fusion with polyaxial screw and rod fixation. Spine (Phila Pa 1976) 2001; 15 26 (22) 2467-2471
    PubMedGoogle Scholar
  • 14 Harris jr. JH, Carson GC, Wagner LK. Radiologic diagnosis of traumatic occipitovertebral dissociation: 1. Normal occipitovertebral relationships on lateral radiographs of supine subjects. AJR Am J Roentgenol 1994; 162 (4) 881-886
    CrossrefPubMedGoogle Scholar
  • 15 Hills MW, Deane SA. Head injury and facial injury: is there an increased risk of cervical spine injury?. J Trauma 1993; 34 (4) 549-553
    CrossrefPubMedGoogle Scholar
  • 16 Jenkins JD, Coric D, Branch jr. CL. A clinical comparison of one- and two-screw odontoid fixation. J Neurosurg 1998; 89 (3) 366-370
    CrossrefPubMedGoogle Scholar
  • 17 Kakarla UK, Chang SW, Theodore N, Sonntag VK. Atlas fractures. Neurosurgery 2010; 66 (3 Suppl) 60-67
    CrossrefPubMedGoogle Scholar
  • 18 Kandziora F, Schnake K, Hoffmann R. Operationsverfahren zur Stabilisierung der oberen Halswirbelsäule. Unfallchirurg 2010; (10) 845-859
    PubMedGoogle Scholar
  • 19 Kandziora F, Stöckle U, König B, Khodadadyan-Klostermann C, Mittlmeier T, Haas NP. C-Bogen-Navigation zur transoralen atlantoaxialen Schraubenplazierung. Chirurg 2001; 72 (5) 593-599
    CrossrefPubMedGoogle Scholar
  • 20 Kenter K, Worley G, Griffin T, Fitch RD. Pediatric traumatic atlanto-occipital dislocation: five cases and a review. J Pediatr Orthop 2001; 21 (5) 585-589
    PubMedGoogle Scholar
  • 21 Koller H, Kolb K, Zenner J, Reynolds J, Dvorak M, Acosta F, Forstner R, Mayer M, Tauber M, Auffarth A, Kathrein A, Hitzl W. Study on accuracy and interobserver reliability of the assessment of odontoid fracture union using plain radiographs or CT scans. Eur Spine J 2009; 18 (11) 1659-1668
    CrossrefPubMedGoogle Scholar
  • 22 Koller H, Resch H, Tauber M, Zenner J, Augat P, Penzkofer R, Acosta F, Kolb K, Kathrein A, Hitzl W. A biomechanical rationale for C1-ring osteosynthesis as treatment for displaced Jefferson burst fractures with incompetency of the transverse atlantal ligament. Eur Spine J 2010; 19 (8) 1288-1298
    CrossrefPubMedGoogle Scholar
  • 23 Lee SC, Chen JF, Lee ST. Management of acute odontoid fractures with single anterior screw fixation. J Clin Neurosci 2004; 11 (8) 890-895
    CrossrefPubMedGoogle Scholar
  • 24 Leidel B, Kanz KG, Mutschler W. Evidenzbasiertes diagnostisches Vorgehen bei Verdacht auf stumpfes HWS-Trauma. Unfallchirurg 2005; 108 (11) 905-919
    CrossrefPubMedGoogle Scholar
  • 25 Leitlinie Polytrauma/Schwerverletztenbehandlung. AWMF-Register 012/019 Klasse S3 2011 2.9 Wirbelsäule. 2011: 232-242
    PubMedGoogle Scholar
  • 26 Levine AM, Edwards CC. The management of traumatic spondylolisthesis of the axis. J Bone Joint Surg Am 1985; 67 (2) 217-226
    PubMedGoogle Scholar
  • 27 Maddox JJ, Rodriguez-Feo 3rd JA, Maddox GE, Gullung G, McGwin G, Theiss SM. Nonoperative treatment of occipital condyle fractures: an outcomes review of 32 fractures. Spine (Phila Pa 1976) 2012; 37 (16) E964-E968
    CrossrefPubMedGoogle Scholar
  • 28 Mayer M, Zenner J, Auffarth A, Atzwanger J, Romeder F, Hitzl W, Lederer S, Resch H, Koller H. Efficacy of anterior odontoid screw fixation in the elderly patient: a CT-based biometrical analysis of odontoid fractures. Eur Spine J 2011; 20 (9) 1441-1449
    CrossrefPubMedGoogle Scholar
  • 29 Mönckeberg JE, Tomé CV, Matías A, Alonso A, Vásquez J, Zubieta JL. CT scan study of atlantoaxial rotatory mobility in asymptomatic adult subjects: a basis for better understanding C1–C2 rotatory fixation and subluxation. Spine 2009; 34 (12) 1292-1295
    CrossrefPubMedGoogle Scholar
  • 30 Mueller FJ, Fuechtmeier B, Kinner B, Rosskopf M, Neumann C, Nerlich M, Englert C. Occipital condyle fractures. Prospective follow-up of 31 cases within 5 years at a level 1 trauma centre. Eur Spine J 2012; 21 (2) 289-94
    CrossrefPubMedGoogle Scholar
  • 31 Mueller FJ, Kinner B, Rosskopf M, Neumann C, Nerlich M, Fuechtmeier B. Incidence and outcome of atlanto-occipital dissociation at a level 1 trauma centre: a prospective study of five cases within 5 years. Eur Spine J 2012; 22 (1) 65-71
    PubMedGoogle Scholar
  • 32 Mueller CA, Roesseler L, Podlogar M, Kovacs A, Kristof RA. Accuracy and complications of transpedicular C2 screw placement without the use of spinal navigation. Eur Spine J 2010; 19 (5) 809-814
    CrossrefPubMedGoogle Scholar
  • 33 Osti M, Philipp H, Meusburger B, Benedetto KP. Analysis of failure following anterior screw fixation of Type II odontoid fractures in geriatric patients. Eur Spine J 2011; 20 (11) 1915-1920
    CrossrefPubMedGoogle Scholar
  • 34 Riesner HJ, Blattert TR, Katscher S, Josten C. Gibt es Therapiealgorithmen bei isolierten und kombinierten Atlas-Frakturen?. Z Orthop Unfall 2009; 147 (4) 472-480
    Article in Thieme ConnectPubMedGoogle Scholar
  • 35 Roy-Camille R, Saillant G, Laville C, Benazet JP. Treatment of lower spine injuries C3 to C7. Spine 1992; (17) 442-447
    PubMedGoogle Scholar
  • 36 Ryan MD, Henderson JJ. The epidemiology of fractures and fracture-dislocations of the cervical spine injury. 1992; 23: 38-40
    PubMedGoogle Scholar
  • 37 Sasso R, Doherty BJ, Crawford MJ, Heggeness MH. Biomechanics of odontoid fracture fixation. Comparison of the one- and two-screw technique. Spine 1993; 18 (14) 1950-1953
    CrossrefPubMedGoogle Scholar
  • 38 Schnake KJ, Pingel A, Scholz M, Kandziora F. Temporary occipito-cervical stabilization of a unilateral occipital condyle fracture. Eur Spine J 2012; 21 (11) 2198-2202
    CrossrefPubMedGoogle Scholar
  • 39 Schnake K, König B, Berth U, Schroeder R, Kandziora F, Stöckle U, Raschke M, Haas N. Genauigkeit der CT-basierten Navigation von Pedikelschrauben an der Brustwirbelsäule im Vergleich zur konventionellen Technik. Unfallchirurg 2004; 107 (2) 104-112
    CrossrefPubMedGoogle Scholar
  • 40 Scholz M, Schnake K, Hoffmann R, Kandziora F. Zementaugmentierte anteriore Densverschraubung bei Densfraktur Typ Anderson II und massiver Osteoporose. Fallbeschreibung. Z Orthop Unfall 2011; 149 (3) 308-311
    Article in Thieme ConnectPubMedGoogle Scholar
  • 41 Stulík J, Suchomel P, Lukás R, Chrobok J, Klézl Z, Taller S, Krbec M. Primary osteosynthesis of the odontoid process: a multicenter study. Acta Chir Orthop Traumatol Cech 2002; 69 (3) 141-148
    PubMedGoogle Scholar
  • 42 Thomann KD, Grosser V, Rauschmann M. Begutachtung von Wirbelsäulenverletzungen. Orthopäde 2010; 39 (3) 312-328
    CrossrefPubMedGoogle Scholar
  • 43 Tomasino A, Parikh K, Koller H, Zink W, Tsiouris AJ, Steinberger J, Härtl R. The vertebral artery and the cervical pedicle: morphometric analysis of a critical neighborhood. J Neurosurg Spine 2010; 13 (1) 52-60
    CrossrefPubMedGoogle Scholar
  • 44 Vaccaro AR, Lim MR, Lee JY. Indications for surgery and stabilization techniques of the occipito-cervical junction. Injury 2005; 36 (Suppl. 02) B44-53
    PubMedGoogle Scholar
  • 45 Xin-Feng L, Li-Yang D, Hua L, Xiao-Dong C. A systematic review of the management of hangmanʼs fractures. Eur Spine J 2006; 15 (3) 257-269
    CrossrefPubMedGoogle Scholar