Servikal sagital denge parametrelerinin 1 ve 2 seviye anterior servikal diskektomi ve füzyon (ACDF) yapılan hastalarda değişimi
Yükleniyor...
Dosyalar
Tarih
2017
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada Ocak 2015-Ocak 2017 arasında Düzce Üniversitesi Beyin ve Sinir Cerrahisi Anabilim Dalı'nda ameliyat edilen 18-70 yaş arası, 1 ve 2 seviye yumuşak servikal disk hernisi olan, radyolojisiyle semptomları ilişkili, 3 hafta tıbbi tedaviden yanıt alamayan ve füzyonlu anterior servikal diskektomi yapılan 55 hasta çalışmaya dahil edilmiş, çalışma retrospektif olarak yürütülmüştür. Etik kurul onayı tez içinde yer almaktadır. Hastaların tümünün ameliyat öncesi ve sonrası servikal MRG ve iki yönlü servikal grafi tetkikleri yapılarak, nörolojik muayeneleri ve Vizuel Analog Skala değerleri ve sagittal denge parametrelerinden servikal lordoz açısı (SLA), C2 tilt (C2T), kranial insidans (Kİ) ve kranial eğim (KE) ölçümleri yapıldı. C2T, SLA, Kİ, KE ölçümleri ile ameliyat sonrası 1. Gün, 15. gün ve 3. aydaki VAS değerleri değerlendirildi. Ameliyat öncesi ve sonrası dönemde ölçülen SLA, KE, C2T, Kİ değerlerindeki değişimlerin ağrı ile korelasyonu değerlendirildi. Ameliyat öncesi ve sonrası dönemde ölçülen Kİ, KE, C2T ve SLA açısı ölçüm değerleri arasında istatistiksel olarak anlamlı fark saptanmadı. Her seviye için ve 2 seviye disk hernileri için de tüm ameliyat sonrası zamanlarda VAS değişimi istatistiksel olarak anlamlıydı. Bu araştırmanın asıl konusu olan, iyileşme ile paralel olarak servikal sagittal denge parametrelerin değişimi konusunda araştırmamızın sonuçları hipotezimizi desteklememekle birlikte, servikal sagittal parametrelerin restorasyonu SLA, KE ve C2T parametreleri için normal popülasyon değerlerine ameliyat sonrası dönemde giderek yaklaşmıştır. SDH sonuçlarında da omurga cerrahisinin diğer alanlarında olduğu gibi klinik düzelme radyolojik düzelmeden önce gelmektedir. Servikal sagittal denge parametrelerin ameliyat sonrası uzun dönem sonuçlarında istatistiksel olarak anlamlı sonuçlar elde edilebileceği düşünülmektedir. Anahtar Sözcükler: Servikal sagittal denge, servikal disk hernisi, cerrahi tedavi, servikal lordoz açısı, C2 tilt, kranial insidans, kranial eğim
In this study, included 55 patients operated (ACDF) in the department of Neurosurgery in Düzce üniversity between January 2015 and January 2017 who are between 18 and 70 years, has one and two level soft cervical disc hernia that had not responded to medical treatment for at last 3 weeks and radiological imaging related with patients symptoms. The study retrospectively designated. Preoperative cervical MRI, antero-posterior and lateral cervical roentgenography, neurological examination, visual analog scala (VAS) values, and among sagittal balance parameters, cervical lordosis angle, cranial insidence, cranial slope, C2 tilt were evaluated. Postoperative antero-lateral roentgenography, cervical lordosis angle, cranial insidence, cranial slope, C2 tilt and VAS values 1th, 15th days, and the third months after the surgery were evaluated. Preoperative and postoperative cervical lordosis angle, C2 tilt, cranial insidence and cranial slope values measured and evaluted the correlation of these parameter changes with pain statistically. There is no statistically significant differences was found between preoperative and postoperative cranial insidence, cranial slope, cervical lordosis angle and C2 tilt values. Statistical analysis showed that change of VAS values is significant for every level and two levels disk hernia all postoperative follow-up times (p?0.001). The main hypothesis of this study, which is surgical treatment with ACDF changes cervical sagittal balance parameters signifintly in parallel aspect weren't supported by our study but, restoration of cervical sagittal parameters for cervical lordosis angle, cranial insidence, kranial slope and C2 tilt parameters come closer values of normal population after surgery period. However these changings weren't statistically significant. In addition, the clinical results of surgical treatment of cervical disc disease generally come before radiological improvement like other areas of spinal surgery. It is thought that statistically significant results can be obtained in the follow-up long term results by observing the cervical sagittal balance parameters approaching the values of normal population in the early postoperative period.
In this study, included 55 patients operated (ACDF) in the department of Neurosurgery in Düzce üniversity between January 2015 and January 2017 who are between 18 and 70 years, has one and two level soft cervical disc hernia that had not responded to medical treatment for at last 3 weeks and radiological imaging related with patients symptoms. The study retrospectively designated. Preoperative cervical MRI, antero-posterior and lateral cervical roentgenography, neurological examination, visual analog scala (VAS) values, and among sagittal balance parameters, cervical lordosis angle, cranial insidence, cranial slope, C2 tilt were evaluated. Postoperative antero-lateral roentgenography, cervical lordosis angle, cranial insidence, cranial slope, C2 tilt and VAS values 1th, 15th days, and the third months after the surgery were evaluated. Preoperative and postoperative cervical lordosis angle, C2 tilt, cranial insidence and cranial slope values measured and evaluted the correlation of these parameter changes with pain statistically. There is no statistically significant differences was found between preoperative and postoperative cranial insidence, cranial slope, cervical lordosis angle and C2 tilt values. Statistical analysis showed that change of VAS values is significant for every level and two levels disk hernia all postoperative follow-up times (p?0.001). The main hypothesis of this study, which is surgical treatment with ACDF changes cervical sagittal balance parameters signifintly in parallel aspect weren't supported by our study but, restoration of cervical sagittal parameters for cervical lordosis angle, cranial insidence, kranial slope and C2 tilt parameters come closer values of normal population after surgery period. However these changings weren't statistically significant. In addition, the clinical results of surgical treatment of cervical disc disease generally come before radiological improvement like other areas of spinal surgery. It is thought that statistically significant results can be obtained in the follow-up long term results by observing the cervical sagittal balance parameters approaching the values of normal population in the early postoperative period.
Açıklama
YÖK Tez No: 471460
Anahtar Kelimeler
Nöroşirürji, Neurosurgery, Ağrı, Pain, Cerrahi, Surgery, Diskektomi, Diskectomy, Füzyon, Fusion, Herniler, Hernia, Manyetik rezonans görüntüleme, Magnetic resonance imaging, Omurga, Spine, Retrospektif çalışmalar, Retrospective studies, Servikal vertebra, Cervical vertebrae, İntervertebral disk deplasmanı, Intervertebral disc displacement, Cervical sagittal balance, cervical disc hernia, surgical treatment, cervical lordosis angle, C2 tilt, cranial insidance, cranial slope
