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DOI: 10.1055/a-0968-9210
Stellenwert der Orthetik für die Wirbelsäule des Erwachsenen – Ergebnisse einer Umfrage und Diskussion der Literatur
Status of orthosis for the adult spine – Result of a national survey and discussion of the literature
Zusammenfassung
Die Möglichkeiten der orthetischen Therapie von Pathologien an der Wirbelsäule sind umfangreich und können unübersichtlich sein. Zunächst muss der betroffenen Lokalisation an der Wirbelsäule Rechnung getragen werden. Darüber hinaus muss das Behandlungsziel, das durch die Orthesenanwendung erreicht werden soll, klar definiert sein. Das Wirkprinzip der verwendeten Orthese sollte daran ausgerichtet sein. Insgesamt sind die therapeutischen Mittel- und Langzeiteffekte der Orthesentherapie für die meisten Pathologien an der Wirbelsäule überwiegend unzureichend. Lediglich bei osteoporotischen Frakturen von älteren Frauen ist ein muskelstimulierender Effekt bei der Verwendung von Aktivorthesen nachgewiesen. Demgegenüber weist eine deutschsprachige Umfrage über die nationale Orthesenanwendung an der Wirbelsäule eine heterogene Anwenderhäufigkeit auf. Insbesondere die häufige Anwendung im Rahmen der konservativen Therapie von traumatischen Wirbelkörperfrakturen als auch die häufige postoperative Orthesenverwendung basiert nicht auf der Grundlage der aktuellen Literatur.
Abstract
There exist a wide variety of orthesis which can be used for the treatment of adult spine pathologies. In order to select an appropriate orthesis the location of the spine must be taken into account. Additionally, the mechanisms of action of orthesis have to be differentiated and should be in accordance with the individual therapy plan. Generally, the overall evidence for beneficial mid- and long-term effects of orthetic therapy is insufficient for most of adult spinal pathologies. As an exception, there has been a positive muscle-stimulating effect of active orthesis in the treatment of osteoporotic fractures of geriatric women improving the quality of life. Interestingly, a national survey on the orthotic application for spinal pathologies has shown a heterogeneous distribution pattern. Particularly the frequent use both in the non-operative treatment of traumatic thoracolumbar fractures and after surgery cannot be sufficiently explained by the current literature.
Schlüsselwörter
Orthesen - Wirbelsäulenpathologien - Halswirbelsäule - thorakolumbale Wirbelsäule - postoperativPublication History
Article published online:
13 August 2020
© Georg Thieme Verlag KG
Stuttgart · New York
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