Diagnostic and Therapeutic Principles in Lumbalgia and Sciatica

Year 1969, Volume: 22 Issue: 3, 649 - 661, 30.09.1969

Güngör Sami Çakırgil

Abstract

Herniation of intervertebral discy may cause of low back pain.
This conditicn should be differatiated from other diaseases which
may give same kind of symptoms.
İn this paper, clinical picture of typical herniated disc problems were reviewed. The most effective treatment ol this problem
is, a complet bed rest until the symptoms of pain dissepears. 'The
main indication for urgent surgery is neurological signs which are
startes suddeniy and progress rapidiy. Although a complet bed rest
for seven to ten days, if the symptoms are not subside or decrease
and also freguentiy relapsas of it are indication secondarly for surgical intervention. Moreaver, especially neurotic type of patient
should be elected and fallowed percaution, for treatment of choies.
On the hysteric type of patient, surgical treatment should not be
performed. On the other hand, on a neurotic type of Wwoven 'with
herniated dise, diagnosis should be made gguickiy and if necessary
an operation should b edone at an early stage. Because, in this type
of patients, if the spmtoms are continue for a long time they may
cause Of psycosis,

Keywords

herniation , intervertebral , discy

Lumbalji Ve Siyataljide Teşhis Ve Tedavi Prensipleri

Abstract

İntervertebral disk hernileri kel (oağrısı meydana getirir. Bu
halde aynı semptomları veren çeşitli hastalıklardan tefrik edilmelidir.
Yukarda tipik disk hernilerinin karakteristik tablosu gözden
geçirildi. Disk hernisinde en müessir tedavi ağrı kaybolana kadar
yatak istirahatıdır. Ani teessüs eden ve süratle ilerleyen nörolojik
bulgular acil müdahale için indikasyon verir. 7 - 10 gün yatak istirahatine rağmen semptomların kaybolma veya azalma göstermemesi. Ayrıca yatak istirahati ile geçtiği halde sık sık nükslerin görülmesi cerrahi müdahale için ikinci derecede gelen indikasyondur.
Ayırıcı teşhiste nörotik tip kadın hastalar üzerinde bilhassa durulmalı ve tedavi dikkatle takip edilmelidir. Konversiyon hysteria'sı
şeklinde olanlarda cerrahi müdahaleden kaçınmalı, buna mukabil
hakiki disk hernisi olan nörotik tip hanım hastalar da da teşhis öncelikle yapılmalı ve gerekirse erken cerrahi müdahaleden kaçınmamalıdır. Çünkü bu tip hastalarda semptomları uzun müddet devamı hastada psikoz sebebi olabilir,

Keywords

herni , intervertebral , disk

References

• 1. HARDY, R. C.: Herniated Intervertebral Lumber Disk. *Texas J. Med.*, 61: 432, 1965.
• 2. LANSCHÜTZ, W. E.: Correlation of the Myelogram with Clinical and Operative Findings in Lumber Disk Lesions. *J. Bone Joint Surg.*, 42 - A: 198, March 1960.
• 3. LOVE, J. G.: Protruded Intervertebral Discs. *Clinical Neurology* by A. B. Baker, Vol. 2, pp. 139, New York: Paul B. Hoeber, 1956.
• 4. SHEMENS, R. E.: Ruptures of Lumbar Intervertebral Disc. *Their Mechanism, Diagnosis and Treatment*. Springfield, Illinois: Charles L. Thomas, 1956.
• 5. WHITE, J. C.: Results in Surgical Treatment of Herniated Lumbar Intervertebral Discs. *Clinical Neurology*, Vol. 13, pp. 42. Baltimore: William Wilkins Company, 1956.
• 6. YOUNG, H. H.: End Results of Removal of Protruded Lumbar Intervertebral Discs with Without Fusion. *Instructional Course Lectures*, F. C. Reynold, Vol. 16, pp. 213. St. Louis: The C. V. Mosby Company, 1959.