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Kompressionssyndrome des N. tibialis

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Nervenkompressionssyndrome

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Zusammenfassung

Der N. tibialis weist in seinem distalen Verlauf am Fuß zwei typische Kompressionsstellen auf, nämlich das seltenere, zu häufig diagnostizierte Tarsaltunnelsyndrom, das in seiner idiopathischen Form zu den umstritteneren Kompressionssyndromen zählt, und die häufiger übersehene, und im Sinne von „Spreizfußbeschwerden“ fehlgedeutete, Morton’sche Metatarsalgie (oder Morton-Neurom). Hochauflösende Sonografie und MRT finden zunehmend Eingang in die Diagnostik des Krankheitsbildes, wobei die Sonografie die bevorzugte Methode zu sein scheint. Die operative Exzision des Morton-Neuroms ist die Therapie der Wahl. Wir bevorzugen den dorsalen Zugang, es gibt jedoch auch Befürworter der plantaren Inzision.

Die symptomatischen Formen des Tarsaltunnelsyndroms durch Raumforderungen im Tarsaltunnel wie Ganglien, Lipome, usw. sind durch die Bildgebung ebenfalls verlässlich zu diagnostizieren und werden in aller Regel operativ behandelt. Bei der diagnostisch oft unklaren, idiopathischen Form ist eher Zurückhaltung geboten, wenn nicht weitere objektive und eindeutige Kriterien wie neurografischer Befund oder bildgebende Befunde vorliegen. Neben der offenen Operation haben endoskopische Verfahren ihre Befürworter.

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Authors and Affiliations

  1. Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Str. 2, 89312, Günzburg, Deutschland

    Gregor Antoniadis Prof. Dr.

  2. Abtsweg 13, 69198, Schriesheim, Deutschland

    Hans Assmus Dr. med.

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  1. Hans Assmus Dr. med.
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  2. Gregor Antoniadis Prof. Dr.
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Editors and Affiliations

  1. Schriesheim, Baden-Württemberg, Germany

    Hans Assmus

  2. Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg, Germany

    Gregor Antoniadis

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Assmus, H., Antoniadis, G. (2015). Kompressionssyndrome des N. tibialis. In: Assmus, H., Antoniadis, G. (eds) Nervenkompressionssyndrome. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55212-0_11

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  • DOI: https://doi.org/10.1007/978-3-642-55212-0_11

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  • Print ISBN: 978-3-642-55211-3

  • Online ISBN: 978-3-642-55212-0

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