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Adoleszente idiopathische Skoliose

Leitfaden für die praktische Anwendung

Adolescent idiopathic scoliosis

Guideline for practical application

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Zusammenfassung

Die idiopathische Skoliose ist mit einer Inzidenz von mehr als 1 % eine relativ häufige Deformität, die durch frühes Erkennen einer erfolgreichen Therapie zugeführt werden kann. Die Ausprägung der Erkrankung wird durch die Messung des Cobb-Winkels im anteroposterioren Röntgenbild der gesamten Wirbelsäule bestimmt. Abhängig vom individuellen Progredienzrisiko wird im Winkelbereich 20–25° mit einer Korsettbehandlung begonnen. Ausreichende Primärkorrektur und compliantes Trageverhalten sind die wesentlichen Prädiktoren für den Therapieerfolg. Ab einem Cobb-Winkel von 40°–50° wird i. d. R. eine Indikation zur Operation gestellt. Bei skeletal reifen Jugendlichen erfolgt die Operation als versteifendes Verfahren, entweder als ventrale oder als dorsale Korrekturspondylodese – abhängig von der Einordnung der Deformität nach der Lenke-Klassifikation. Im Sinn eines bestmöglichen Behandlungsergebnisses sollte sowohl die konservative als auch die operative Therapie durch einen Skoliosespezialisten geführt werden.

Abstract

Juvenile or adolescent idiopathic scoliosis is a relatively common spinal deformity, with an incidence of more than 1 %. Early diagnosis can lead to successful therapy. In the case of pathological clinical findings, the anteroposterior X‑ray of the whole spine leads the way to the correct grading, according to Cobb angle measurement. Depending on the individual risk of progression, brace treatment will be started with a Cobb angle range of 20–25°. Important predictors of therapeutic success are sufficient primary corrective power and patient compliance. COBB angles of 40–50° usually lead to the recommendation for surgery, which is performed as either anterior or posterior spinal fusion in skeletally mature adolescents, depending on the grade of the deformity according to Lenke’s classification. To achieve the best possible results, it is recommended that both conservative and surgical treatments are carried out by scoliosis specialists.

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Authors and Affiliations

  1. Interdisziplinäre Wirbelsäulenchirurgie, AKG Klinik Hohwald GmbH, Hohwaldstraße 40, 01844, Neustadt in Sachsen, Deutschland

    J. Seifert Chefarzt

  2. Orthopädisch-Unfallchirurgisches Zentrum des Universitätsklinikums Dresden, Medizinische Fakultät der TU-Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland

    F. Thielemann & P. Bernstein

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  1. J. Seifert Chefarzt
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  2. F. Thielemann
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  3. P. Bernstein
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Correspondence to J. Seifert Chefarzt.

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J. Seifert, F. Thielemann und P. Bernstein geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Seifert, J., Thielemann, F. & Bernstein, P. Adoleszente idiopathische Skoliose. Orthopäde 45, 509–517 (2016). https://doi.org/10.1007/s00132-016-3274-5

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