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Skoliose im Kindes- und Jugendalter

Scoliosis in childhood and adolescence

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Zusammenfassung

Hintergrund

Skoliosen im Kindes- und Jugendalter benötigen häufig aufwendige konservative und operative Therapieverfahren. Zur Vermeidung unerfreulicher Verläufe ist die detaillierte Kenntnis des Wachstumsverhaltens, der Prognose und von Begleitproblematiken unerlässlich.

Ziel der Arbeit

Kenntnisse zu Ätiologie, Prognose, Diagnostik und Therapie von Wirbelsäulendeformitäten im Wachstumsalter sollen vermittelt werden.

Methode

Die vorliegende Arbeit beruht auf einer selektiven Literaturrecherche und auf den Ergebnissen mehrerer eigener prospektiver und retrospektiver Untersuchungen.

Ergebnisse

Abhängig von Ätiologie und Patientenalter ist eine detaillierte und interdisziplinäre Diagnostik nötig. Konservative Therapien, z. B. die Versorgung mithilfe eines Chêneau-Korsetts, können Krümmungen bestenfalls aufhalten, aber nicht auf lange Sicht umkehren. Operative Therapien mit wachstumsfreundlichen Implantaten sind aufwendig sowie mit Komplikationen und Mehrfacheingriffen verbunden. Von extern zu verlängernde, magnetische Implantate vermindern die Zahl notwendiger operativer Eingriffe, tragen aber nicht zur Erhöhung der Lebensqualität bei.

Diskussion

Unterschiedliche Formen der Skoliose benötigen verschiedene Therapieansätze. Wichtig ist die Kenntnis von der Art der Skoliose und dem wahrscheinlichen Verlauf. Abhängig davon muss die Familie entsprechend beraten und ein Therapiekonzept entwickelt werden. Wachstumsfreundliche Implantate werden als Übergangslösung bis zur Wirbelsäulenversteifung eingesetzt.

Abstract

Background

Scoliosis in childhood and adolescence often requires complex conservative and surgical treatment procedures. In order to avoid unpleasant courses detailed knowledge of growth behavior, prognosis and accompanying problems is essential.

Objective

The aim of this article is to convey knowledge of the etiology, prognosis, diagnostics and treatment of spinal deformities during the growth phase.

Method

This article is based on a selective literature search and on the results of several own prospective and retrospective studies.

Results

A detailed and interdisciplinary diagnosis is necessary depending on the etiology and age of the patient. Conservative treatment, e.g. using a Chêneau brace, can at best stop curvature but cannot reverse it in the long run. Surgical treatment with growth-friendly implants are complex and associated with complications and multiple interventions. Magnetic implants that can be extended externally reduce the number of surgical interventions but do not contribute to increasing the quality of life.

Conclusion

Different forms of scoliosis require different treatment approaches. It is important to know the type of scoliosis and the probable course. Depending on this, the family must be advised accordingly and a treatment concept must be developed. Growth-friendly implants are used as a temporary solution until definitive spinal fusion is performed.

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Author information

Authors and Affiliations

  1. Kinderorthopädie, Operatives Kinderzentrum, Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland

    A. K. Hell, K. Tsaknakis & H. M. Lorenz

  2. Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland

    S. Lippross

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  1. A. K. Hell
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  4. H. M. Lorenz
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Correspondence to A. K. Hell.

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Interessenkonflikt

A.K. Hell, K. Tsaknakis, S. Lippross und H.M. Lorenz geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für die abgebildeten Patientenbilder liegen Einverständniserklärungen der Eltern der abgebildeten Kinder und Jugendlichen vor.

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Hell, A.K., Tsaknakis, K., Lippross, S. et al. Skoliose im Kindes- und Jugendalter. Monatsschr Kinderheilkd 168, 917–929 (2020). https://doi.org/10.1007/s00112-020-00977-x

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