Enstrumantasyonlu posterior dekompresyon yapılan lomber dar kanal olgularında ameliyat sonrası yaşam kalitesinin değerlendirilmesi
Yükleniyor...
Dosyalar
Tarih
2009
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Dar kanal, medulla spinalise ve sinir kökleri¬ne bası yapacak şekilde, ke¬mik ve yumuşak dokular tarafından spinal kana¬lın, sinir kökü kanallarının ve nöral foramenlerin daralmasıyla ortaya çıkan klinik tablo olarak ta¬nımlanabilir. Yaşlı hastalarda bel ağrısı ve radikülopatinin en sık sebebidir. Aktivite ile artan ağrı, nörojenik kladikasyo ve uyuşma gibi lomber fleksiyonla azalan ve lomber ekstansiyonla artan şikayetler içerir. Retrospektif olarak yapılan bu çalışmada, kliniğimizde Mart 2004 - Nisan 2008 tarihleri arasında enstrumantasyonlu posterior dekompresyon yapılan 64 dejeneratif lomber dar kanallı olgunun arşiv kayıtları ve dosyaları incelendi. Ameliyat sonrası en az 1. yılda olmak üzere, hastalar tekrar muayene edilerek ameliyat sonrası son durumları dejeneratif lomber dar kanal hasta formu ve Japanese Orthopaedic Association formu doldurularak değerlendirildi. Olguların ortalama olarak yaşları 59,9, takip süreleri 27,9 ay, ameliyat sonrası iyileşme oranları (Japanese Orthopaedic Association skoru) %63,5 idi. Buna göre olguların ameliyat öncesi ve sonrası doldurulan Japanese Orthopaedic Association skorlamalarında istatistiksel olarak iyileşme yönünde anlamlı fark bulundu (p<0,001). İyileşme oranı (Japanese Orthopaedic Association skoru) ile olguların cinsiyeti (p=0,651), yaşı (p=0,192), ameliyat öncesi şikayet süresi (p=0,095), ameliyattan sonra geçen süre (p=0,933), uygulanan laminektomi seviyelerinin sayısı (p=0,997), ameliyat öncesi eşlik eden deformite varlığı (p=0,773) ve sistemik hastalık varlığı karşılaştırıldığında istatistiksel olarak anlamlı ilişki bulunmadı (p=0,052). Ancak sistemik hastalığı olmayanlarda Japanese Orthopaedic Association skorunun daha iyi (%83,3) olduğu görüldü. Sonuç olarak, ileri derecede dejeneratif lomber dar kanallı olguların enstrumantasyonlu posterior dekompresyon tedavisinden fayda gördüğü, iyileşme oranını etkileyen sekonder faktörlerin bulunmadığı ve ameliyat sonrsı hiçbir olguda cerrahiye bağlı instabilite izlenmediği gösterilmiştir. Anahtar kelimeler: Dar kanal, Yaşam kalitesi, Enstrumantasyonlu posterior dekompresyon.
Spinal stenosis can be described as stenosis of spinal canal, neuronal foramina and canal of neuronal roots by bone and soft tissue that presses medulla spinalis and neuronal roots. In elderly patients spinal stenosis is the most common reason of low back pain and radiculopathy. Symptoms of spinal stenosis are pain increasing with activity, neurogenic claudication and paresthesia all of which are increasing with lumbar extension and decreasing with lumbar flexion. In this retrospective study the files of 64 cases who underwent posterior decompression surgery with instrumentation for degenerative lumbar spinal stenosis between March 2004-April 2008 were documented. Patients were evaluated with Japanese Orthopaedic Association form, form of degenerative lumbar spinal stenosis and the last orthopedic inspection findings at a minimum of one year postoperatively. The mean age of patients were 59.9 years and mean follow-up time was 27.9 months. Postoperatively Japanese Orthopaedic Association score improved in %63.5 of patients. According to this postoperatively improvement of Japanese Orthopaedic Association scores are founded statistically significant (p<0.001). Gender (p=0.651), age (p=0.192), the time pasing with complaint (p=0.095), the time passed after surgery (p=0.933), the number of laminectomy level (p=0.997), deformity before operation (p=0.773) and systemic disease were not statistically correlated with improvement of Japanese Orthopaedic Association scores (p=0.052). But Japanese Orthopaedic Association scores were found to be better (%83) in the cases which didn?t have systemic disease. As a result, posterior decompression surgery with instrumentation is a useful therapy for the patients with severe degenerative lumbar spinal stenosis; there is no secondary factor affecting improvement and it has been shown that instability after surgery was not seen in any of the patient. Keywords: Spinal stenosis, Health related quality of life, Posterior decompression surgery with instrumentation
Spinal stenosis can be described as stenosis of spinal canal, neuronal foramina and canal of neuronal roots by bone and soft tissue that presses medulla spinalis and neuronal roots. In elderly patients spinal stenosis is the most common reason of low back pain and radiculopathy. Symptoms of spinal stenosis are pain increasing with activity, neurogenic claudication and paresthesia all of which are increasing with lumbar extension and decreasing with lumbar flexion. In this retrospective study the files of 64 cases who underwent posterior decompression surgery with instrumentation for degenerative lumbar spinal stenosis between March 2004-April 2008 were documented. Patients were evaluated with Japanese Orthopaedic Association form, form of degenerative lumbar spinal stenosis and the last orthopedic inspection findings at a minimum of one year postoperatively. The mean age of patients were 59.9 years and mean follow-up time was 27.9 months. Postoperatively Japanese Orthopaedic Association score improved in %63.5 of patients. According to this postoperatively improvement of Japanese Orthopaedic Association scores are founded statistically significant (p<0.001). Gender (p=0.651), age (p=0.192), the time pasing with complaint (p=0.095), the time passed after surgery (p=0.933), the number of laminectomy level (p=0.997), deformity before operation (p=0.773) and systemic disease were not statistically correlated with improvement of Japanese Orthopaedic Association scores (p=0.052). But Japanese Orthopaedic Association scores were found to be better (%83) in the cases which didn?t have systemic disease. As a result, posterior decompression surgery with instrumentation is a useful therapy for the patients with severe degenerative lumbar spinal stenosis; there is no secondary factor affecting improvement and it has been shown that instability after surgery was not seen in any of the patient. Keywords: Spinal stenosis, Health related quality of life, Posterior decompression surgery with instrumentation
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Ortopedi ve Travmatoloji, Orthopedics and Traumatology, Dar Kanal, Spinal Stenosis, Yaşam Kalitesi, Health Related Quality of Life, Enstrumantasyonlu Posterior Dekompresyon, Posterior Decompression Surgery With Instrumentation
