Lumbaler Bandscheibenvorfall: Konservative Und Operative Behandlung
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Erorterungen urn die angemessene Therapie des lumhalen Bandscheiben- vorfalls fiihren nieht selten zu der Frage, db derartige Falle grundsatzlieh konservativ oder operativ behandelt werden sollen. Dies hedeutet aber zu- gleieh eine unzulassige Vereinfachung, weil nieht beriicksiehtigt wird, daB es "den lum'halen Bandsehdbenvorfall" als einheitliehes Krankheitsbild nieht giibt. Ferner sind unter den Begritfen konservative und operative Therapie jeweils weitgehend versehiedenartige MaBnahmen zusammengefaBt. Der lumbale Bandseheibenvorfall kann yom fliichtigen Lumbago bis hin zum vollstandigen Caudasyndrom mannigfaItige klinisehe Bilder pragen. Daher laBt sieh die Wirksamkeit versehiedener Therapieformen nur an Fallen ahn- licher Symptomatik iiberpriifen. Hierbei miissen die verschiedenartigen kon- servativen und operativen Behandlungsmerhoden einzeln gewiirdigt weroen, umschlieBt doch der Sammelbegriff der konservativen Therapie nicht nur den medikamentosen Heilschatz, sondern auch die miteinander nur schwer vergleichbaren Formen der Ruhigstellung und Entlastung der Wirbelsaule dureh Lagerung, Extension und redressierende MaBnahmen. Auf der Seite der operativen Verfahren fin'den sich neben den Methoden der Wurzel- entlastung auch die Versterfungsoperationen. Das Ziel, den fiir jeden Einzelfall optimalen rherapeullischen Weg zu finden, schien nur erreichbar, wenn die Moglichkeiten uud Grenzen der einzelnen Therapieformen an einem nach genau uml'issenen Syndromen aufgeteilten groBen Bedbachtungsgut iiberpriift werden konnten. Daher ent- schlossen wir uns, das Krankengut unserer Klin ken naeh einheitlichen Ge- sic'htspunkten von einer Gruppe erfahrener Mita1'lbeiter verschiedener Fach- rich tung nachuntersuehen zu las-sen. Das hier vorgelegte Ergebnis ist weit mehr als ein 'Erfahrungsbericht iiber die Resultate orthopadischer, neuro- chirurgischer oder neurologischer HeilmaBnahmen.
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