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Lomber dejeneratif disk hastalığının total disk protezi ile tedavisi

Year 2007, Volume: 41 Issue: 4, 281 - 285, 05.12.2007

Abstract

Amaç: Ağrılı dejeneratif lomber disk hastalığı nedeniyle ProDisc II total disk protezi (TDP) uygulanan olguların klinik ve radyografik sonuçları değerlendirildi.
Çalışma planı: Dejeneratif disk hastalığı (DDH) tanısıyla lumbar TDP uygulanan 34 hasta (25 kadın, 9 erkek; ort. yaş 44; dağılım 37-54) çalışmaya alındı. Toplam 62 TDP prosedürü olmak üzere, 12 olguya tek, 17 olguya iki, dört olguya üç, bir olguya ise dört seviyeli lomber TDP uygulandı. Olgular ameliyat öncesinde ve ameliyat sonrası 3, 6, 12, 24. aylarda klinik ve radyografik olarak değerlendirildi. Klinik değerlendirmede görsel analog skala (GAS) ve Oswestry Engellilik İndeksi (OEİ) kullanıldı. Radyografik değerlendirmede, lomber lordoz açısı, tutulan diskin yüksekliği ile fleksiyon-ekstansiyon açıları ölçüldü. Ortalama takip süresi 29.3 ay (dağılım 24-39 ay) idi.
Sonuçlar: Olguların bel ve bacak ağrıları en geç üçüncü ayda tama yakın düzeldi. Klinik değerlendirmede, ameliyat öncesi 59.6 olan OEİ skoru ameliyat sonrası 24. ayda 19.8’e, GAS skoru ise 7.8’den 1.0’e geriledi. Lomber lordoz ameliyat öncesinde 52.6°, ameliyat sonrasında 57.1° olarak ölçüldü. Disk yüksekliği implantasyon yapılan seviyelerde 4.6 mm’den 12.1 mm’ye yükseldi. Fleksiyon-ekstansiyon açısı L5-S1 seviyesinde 2.8 dereceden 8.4 dereceye; L4-5 seviyesinde ise 2.6 dereceden 9.8 dereceye yükseldi. Total disk protezi uygulanan tüm disklerde fleksiyon-ekstansiyon açısında düzelme ortalama 7.2° bulundu.
Çıkarımlar: Lomber disk protezi, dejeneratif disk hastalığının cerrahi tedavisinde hastaların fonksiyonları ve yaşam kalitelerinin sürdürülmesi açısından önemli avantajlara sahiptir.

Total disc prosthesis for painful degenerative lumbar disc disease

Year 2007, Volume: 41 Issue: 4, 281 - 285, 05.12.2007

Abstract

Objectives: We evaluated clinical and radiographic results of patients treated by the ProDisc II total disc prosthesis (TDP) for painful degenerative lumbar disc disease.
Methods: The study included 34 patients (25 females, 9 males; mean age 44 years; range 37 to 54 years) who underwent a total of 62 lumbar TDP procedures for degenerative lumbar disc disease. Lumbar disc replacement involved one level in 12 cases, two levels in 17 cases, three levels in four cases, and four levels in one case. Clinical and radiographic assessments were made preoperatively and at 3, 6, 12, and 24 months postoperatively. Clinical evaluations were made with a visual analog scale (VAS) and the Oswestry Disability Index (ODI). Radiographic parameters included lumbar lordotic angle, the height and flexion-extension range of the affected discs. The mean follow-up period was 29.3 months (range 24 to 39 months).
Results: Low back pain and lower extremity pain showed near-complete improvement up to the third postoperative month. At the end of the 24th month, preoperative ODI and VAS scores of 59.6 and 7.8 decreased to 19.8 and 1.0, respectively. Preoperative and postoperative lumbar lordotic angles were 52.6° and 57.1°, respectively. The mean disc height of implanted discs increased from 4.6 mm to 12.1 mm postoperatively. The mean flexion-extension angle increased from 2.8° to 8.4° at L5-S1, and from 2.6° to 9.8° at L4-5. The overall improvement in the mean flexion-extension angle was 7.2°.
Conclusion: Lumbar disc prosthesis offers significant advantages in terms of functional improvement and increased quality of life in the surgical treatment of degenerative disc disease.

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Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Omer Karatoprak This is me

Mehmet Aydogan This is me

Cagatay Ozturk This is me

Cuneyt Mirzanli This is me

Mehmet Tezer This is me

Azmi Hamzaoglu This is me

Publication Date December 5, 2007
Published in Issue Year 2007 Volume: 41 Issue: 4

Cite

APA Karatoprak, O., Aydogan, M., Ozturk, C., Mirzanli, C., et al. (2007). Total disc prosthesis for painful degenerative lumbar disc disease. Acta Orthopaedica Et Traumatologica Turcica, 41(4), 281-285.
AMA Karatoprak O, Aydogan M, Ozturk C, Mirzanli C, Tezer M, Hamzaoglu A. Total disc prosthesis for painful degenerative lumbar disc disease. Acta Orthopaedica et Traumatologica Turcica. December 2007;41(4):281-285.
Chicago Karatoprak, Omer, Mehmet Aydogan, Cagatay Ozturk, Cuneyt Mirzanli, Mehmet Tezer, and Azmi Hamzaoglu. “Total Disc Prosthesis for Painful Degenerative Lumbar Disc Disease”. Acta Orthopaedica Et Traumatologica Turcica 41, no. 4 (December 2007): 281-85.
EndNote Karatoprak O, Aydogan M, Ozturk C, Mirzanli C, Tezer M, Hamzaoglu A (December 1, 2007) Total disc prosthesis for painful degenerative lumbar disc disease. Acta Orthopaedica et Traumatologica Turcica 41 4 281–285.
IEEE O. Karatoprak, M. Aydogan, C. Ozturk, C. Mirzanli, M. Tezer, and A. Hamzaoglu, “Total disc prosthesis for painful degenerative lumbar disc disease”, Acta Orthopaedica et Traumatologica Turcica, vol. 41, no. 4, pp. 281–285, 2007.
ISNAD Karatoprak, Omer et al. “Total Disc Prosthesis for Painful Degenerative Lumbar Disc Disease”. Acta Orthopaedica et Traumatologica Turcica 41/4 (December 2007), 281-285.
JAMA Karatoprak O, Aydogan M, Ozturk C, Mirzanli C, Tezer M, Hamzaoglu A. Total disc prosthesis for painful degenerative lumbar disc disease. Acta Orthopaedica et Traumatologica Turcica. 2007;41:281–285.
MLA Karatoprak, Omer et al. “Total Disc Prosthesis for Painful Degenerative Lumbar Disc Disease”. Acta Orthopaedica Et Traumatologica Turcica, vol. 41, no. 4, 2007, pp. 281-5.
Vancouver Karatoprak O, Aydogan M, Ozturk C, Mirzanli C, Tezer M, Hamzaoglu A. Total disc prosthesis for painful degenerative lumbar disc disease. Acta Orthopaedica et Traumatologica Turcica. 2007;41(4):281-5.