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<article  article-type="case-report"        dtd-version="1.4">
            <front>

                <journal-meta>
                                    <journal-id></journal-id>
            <journal-title-group>
                                                                                    <journal-title>Ankara Üniversitesi Tıp Fakültesi Mecmuası</journal-title>
            </journal-title-group>
                            <issn pub-type="ppub">0365-8104</issn>
                                        <issn pub-type="epub">1307-5608</issn>
                                                                                            <publisher>
                    <publisher-name>Ankara University</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id/>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>Orthopaedics</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>Ortopedi</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                        <trans-title-group xml:lang="en">
                                    <trans-title>A Rational Approach to Failures of Lumbar Disk Surgery: The Orthopedist&#039;s Approach</trans-title>
                                </trans-title-group>
                                                                                                                                                                                                <article-title>Lumbar Disk Cerrahisi Başarısızlıklarının Ortopedik Yönü</article-title>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                <name>
                                    <surname>Çakırgil</surname>
                                    <given-names>Güngör Sami</given-names>
                                </name>
                                                                    <aff>ANKARA ÜNİVERSİTESİ, ANKARA TIP FAKÜLTESİ</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="19741230">
                    <day>12</day>
                    <month>30</month>
                    <year>1974</year>
                </pub-date>
                                        <volume>27</volume>
                                        <issue>3-4</issue>
                                        <fpage>941</fpage>
                                        <lpage>950</lpage>
                        
                        <history>
                                    <date date-type="received" iso-8601-date="19740901">
                        <day>09</day>
                        <month>01</month>
                        <year>1974</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="19741230">
                        <day>12</day>
                        <month>30</month>
                        <year>1974</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 1947, Ankara Üniversitesi Tıp Fakültesi Mecmuası</copyright-statement>
                    <copyright-year>1947</copyright-year>
                    <copyright-holder>Ankara Üniversitesi Tıp Fakültesi Mecmuası</copyright-holder>
                </permissions>
            
                                                                                                <trans-abstract xml:lang="en">
                            <p>Persistence of symptoms following disc surgery is not uncommon. Such problems require more methodical and multifaceted work. The first and only path to success is meticulousness in the initial diagnosis. For this purpose, internal, orthopedic, neurological, neurosurgical, and psychiatric examinations should be performed; radiographic, myelographic, electromyographic, discographic examinations, and the application of a cast should be considered when possible. Incorrect initial diagnosis is the most common cause of disc surgery failure. The patient&#039;s existing organic and emotional conditions should be carefully investigated. Undertaking treatment without a complete diagnosis will only exacerbate the patient&#039;s existing suffering. After diagnosis, an absolute indication must be given for conservative or surgical treatment. Surgical treatment may include neurosurgical exploration, spinal fusion, or A combination of these two is performed. If spinal fusion is indicated, it should be a &quot;Postero-lateral Fusion&quot; using autogenous iliac grafts.</p></trans-abstract>
                                                                                                                                    <abstract><p>Disk ameliyatını takiben, semptomların sebat etmesi nadir bir durum değildir. Bu gibi problem, daha metodik ve çok yönlü bir çalışma kereklirir. İlmen ilk ve yegâne başarı yolu, başlangıçtaki teşhiste çok hassasiyet göstermektir. Bu maksatla dahili, ortopedik, nörolojik, nöroşirurjik ve psikiatrik muayeneler yapılmalı; radyografik, myelografik, elektromyografik, yapılabildiği takdirde diskografik tetkiklere ve tecrübi alçı korsa tatbikine başvurulmalıdır. İlk teşhisin yanlış yapılması, disk cerrahisinin başarısızlığında en yaygın sebeptir. Hastada mevcut organik ve emosyonel durumlar dikkatle araştırılmalıdır. Tam teşhis konmadan girişilecek tedavi hastanın mevcut izdırabının daha da fazlalaşmasına yol açar. Teşhisten sonra, tedavinin konservatif veya cerrahi yönlerde yapılacağı hususunda mutlak indikasyon konmalıdır. Cerrahi tedavi nöroşirurjikal eksplorasyon, spinal füzyon veya. bu ikisinin kombinasyonu şekillerinde uygulanır. Eğer spinal füzyon indikasyonu konursa bu, otojenöz iliak greflerinden istifade edilerekyapılacak «Postero - lateral Füzyon» olmalıdır.</p></abstract>
                                                            
            
                                                                                        <kwd-group>
                                                    <kwd>Lumbar disk cerrahisi başarısızlıkları</kwd>
                                                    <kwd>  Spinal füzyon</kwd>
                                                    <kwd>  Posterolateral füzyon</kwd>
                                            </kwd-group>
                            
                                                <kwd-group xml:lang="en">
                                                    <kwd>Lumbar disc surgery failures</kwd>
                                                    <kwd>  Spinal fusion</kwd>
                                                    <kwd>  Posterolateral fusion</kwd>
                                            </kwd-group>
                                                                                                                                        </article-meta>
    </front>
    <back>
                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
                        <mixed-citation publication-type="journal">1. Armstrong, J. R. (1951). The causes of unsatisfactory results from the operative treatment of lumbar disc lesions. J. Bone Joint Surg., 33B: 31.</mixed-citation>
                    </ref>
                                    <ref id="ref2">
                        <label>2</label>
                        <mixed-citation publication-type="journal">2. Coventry, N. B. &amp; Stauffer, R. N. (1969). The Multiply Operated Back. Amer. Acad. Orthop. Surgeons Symposium on the Spine. Mosby.</mixed-citation>
                    </ref>
                                    <ref id="ref3">
                        <label>3</label>
                        <mixed-citation publication-type="journal">3. Dandy, W. E. (1929). Loose Cartilage from Intervertebral Disc Simulating Tumor of the Spinal Cord. Arch. Surg., 19: 660.</mixed-citation>
                    </ref>
                                    <ref id="ref4">
                        <label>4</label>
                        <mixed-citation publication-type="journal">4. Goldthwait, J. E. (1911). The Lumbo-sacral Articulation: An Explanation of Many Cases of &quot;Lumbago&quot; and &quot;Sciatica&quot;. J. Bone Joint Surg., 164: 365.</mixed-citation>
                    </ref>
                                    <ref id="ref5">
                        <label>5</label>
                        <mixed-citation publication-type="journal">5. Mixter, W. J. &amp; Barr, J. S. (1934). Rupture of the Intervertebral Disc into the Spinal Canal. New Engl. J. Med., 211: 210.</mixed-citation>
                    </ref>
                                    <ref id="ref6">
                        <label>6</label>
                        <mixed-citation publication-type="journal">6. O&#039;Connel, J. E. A. (1934). Protrusions of the Lumbar Intervertebral Discs. J. Bone Joint Surg., 33B: 8.</mixed-citation>
                    </ref>
                                    <ref id="ref7">
                        <label>7</label>
                        <mixed-citation publication-type="journal">7. Coventry, M. B. &amp; Stauffer, R. N. (Unpublished). Anterior Interbody Lumbar Fusion: Mayo Clinic Experience.</mixed-citation>
                    </ref>
                                    <ref id="ref8">
                        <label>8</label>
                        <mixed-citation publication-type="journal">8. Coventry, M. B. &amp; Stauffer, R. N. (Unpublished). Posterolateral Lumbar Fusion: Mayo Clinic Experience.</mixed-citation>
                    </ref>
                            </ref-list>
                    </back>
    </article>
