Lomber disk hernilerinin cerrahi tedavisinde mikroforaminotomi yöntemi
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Tarih
2007
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info:eu-repo/semantics/openAccess
Özet
Bu çalışmada lomber disk hernisinin cerrahi tedavisinde sık kullanılan mikrodiskektomi yöntemine alternatif oluşturabilecek yeni bir yöntem olan mikroforaminotomi girişimi irdelenmektedir. Lamina üzerinde yüksek hızlı drill ile açılan bir mikroforamen ile bası altındaki sinir kökünün doğrudan rahatlatılması amaçlanmıştır. Çalışma lomber disk hernisi nedeniyle ameliyat edilen 21 hasta üzerinde etik kurul onayıyla ve bilgilendirilerek yapılmıştır. Hepsi aynı cerrah tarafından ameliyat edilen hastalar preoperatif ve postoperatif dönemde Vizüel analog skala, Roland-Morris bel ağrısı ve engellilik sorgu formu ve Oswestry bel ağrısı sorgulama formu kullanılarak, sadece postoperatif dönemde ise hasta tatmin formu ile değerlendirildiler. Preoperatif dönemde rutin biyokimyasal ve hematolojik tetkikler, manyetik rezonans görüntüleme, bilgisayarlı tomografi, lumbosakral direkt grafiler ve gereken hastalarda elektromyografi incelemeleri yapıldı. Kullanılan skalaların sonuçları, Shapiro-Wilk, Wilcoxon T istatistik testleri ve Spearman korelasyon analizi kullanılarak değerlendirildi. Vizüel Analog Skala'da preoperatif ortalama değer 9.8 iken, postoperatif dönemde ortalama 1.7 idi. Diğer iki skalanın sonuçları da istatistiksel anlamlılık taşıyordu. Yöntemler arasında istatistiksel korelasyon vardı. Hiçbir hastada komplikasyon gözlenmedi. Postoperatif dönemde uzun süreli takibe alınan hastaların birisi dışında memnuniyet tamdı. Literatürle kıyaslanan bulgular benzer çalışmaların sonuçları ile uyumluydu. Çalışmamızın sonucunda mikrodiskektominin farklı bir uygulaması olan mikroforaminotomi yönteminin lomber disk hernilerinin cerrahi tedavisinde kullanılabilecek başarılı bir alternatif olduğu kanısına varıldı. Anahtar kelimeler: lumbar vertebra, disk hernisi, diskektomi, foraminotomi, minimal invaziv
In this study microforaminotomy surgery, a new method that may be alternative to microdiscectomy which is often used in the surgical treatment of lumbar disc hernia was examined. It was aimed to directly ease the nerve root under pressure with a microforamen opened on the lamina by using a high speed drill. The study was performed with the approval of ethics committee on 21 patients, which were informed and operated because of lumbar disc hernia. The patients, which were operated by the same surgeon, were evaluated by using visual analogue scale, Roland-Morris disability questionnaire and Oswestry disability index in the preoperative period and by using ?patient satisfaction form? after the operation. During the preoperative period, routine biochemical and hematological examinations, magnetic resonance imaging, computerized tomography, lumbosacral direct graphy and for the required patients, electromyography examinations were done. The results of the scales were evaluated by using Shapiro-Wilk, Wilcoxon T statistical tests and Spearman correlation analysis. In the visual analogue scale, while the preoperative mean value was 9.8, postoperative mean value was 1.7. The results of the other two scales were also statistically significant. A statistical correlation existed between the methods. None of the patients suffered complications. Except for one, all of the patients, which were followed for a long time in the postoperative period, were completely satisfied. The results were compatible with the results of the other studies in the literature. As a conclusion of our study, it was thought that microforaminotomy method, which is a different application of microdiscectomy, is a successful alternative that can be used in the surgical treatment of lumbar disc hernias. Key Words: lumbar vertebra, disc hernia, discectomy, foraminotomy, minimal invasive
In this study microforaminotomy surgery, a new method that may be alternative to microdiscectomy which is often used in the surgical treatment of lumbar disc hernia was examined. It was aimed to directly ease the nerve root under pressure with a microforamen opened on the lamina by using a high speed drill. The study was performed with the approval of ethics committee on 21 patients, which were informed and operated because of lumbar disc hernia. The patients, which were operated by the same surgeon, were evaluated by using visual analogue scale, Roland-Morris disability questionnaire and Oswestry disability index in the preoperative period and by using ?patient satisfaction form? after the operation. During the preoperative period, routine biochemical and hematological examinations, magnetic resonance imaging, computerized tomography, lumbosacral direct graphy and for the required patients, electromyography examinations were done. The results of the scales were evaluated by using Shapiro-Wilk, Wilcoxon T statistical tests and Spearman correlation analysis. In the visual analogue scale, while the preoperative mean value was 9.8, postoperative mean value was 1.7. The results of the other two scales were also statistically significant. A statistical correlation existed between the methods. None of the patients suffered complications. Except for one, all of the patients, which were followed for a long time in the postoperative period, were completely satisfied. The results were compatible with the results of the other studies in the literature. As a conclusion of our study, it was thought that microforaminotomy method, which is a different application of microdiscectomy, is a successful alternative that can be used in the surgical treatment of lumbar disc hernias. Key Words: lumbar vertebra, disc hernia, discectomy, foraminotomy, minimal invasive
Açıklama
Anahtar Kelimeler
Nöroşirürji, Neurosurgery
