Vertebra Tüberkülozu Tedavisinde Vertebral Osteotomi ve Anterior Spinal Füzyon Ameliyatı (İlk 20 vak'ada ameliyat bulguları ve tedavi neticeleri)

Year 1972, Volume: 25 Issue: 5 , 996 - 1010 , 31.10.1972

Güngör Sami Çakırgil

https://izlik.org/JA69RB53AM

Abstract

Vertebra tüberkülozu tedavisinde absenin boşaltılması, sekestrize kemik ve intervertebral disklerle birlikte bütün avaskuler kemik dokularının eksizyonundan sonra boşalan sahaya kot greflerinin yerleştirilmesi şeklinde tatbik edilen metod, diger konservatif tedavi metodları ve posterior füzyon ameliyatlarından daha başarılı sonuçlar verir. Birden çok vertebrayı içine alan vakalarda bile, en iyi tedavi neticeleri erken cerrahi müdahele yapılan hastalarda elde edilir. Tedavi bakımından aşağıdaki noktalara bilhassa dikkat edilmelidir.
1 — Anterior aproç, hasta bölgeye daha rahat ulaşmayı sağlar. Bu bölge çokkere, röntgen filmlerinde görülenden daha geniş bir sahayı içine alır.
2 — Solid füzyonun sağlanabilmesinde esas prensip, bütün avaskuler kemik dokusu eksizyonunun yapılmasıdır.
3 — Avaskuler bölgenin eksizyonu ve kot greflerinin tatbiki, en yüksek başarılı neticeleri verir.
4 — Anterior füzyon ameliyatı hastanede kalma süresini kısaltır.
5 — Pott'un da dediği gibi «Vertebra cisimleri arasında füzyonun sağlanması, belkemiği tüberkülozunda tedavi objesini teşkil eder, solid ossöz ankiloz tüberküloz nüksünü ortadan kaldırır».

Keywords

Tüberküloz , Vertebra tüberkülozu , Abse drenajı

Vertebral Osteotomy and Anterior Spinal Fusion for the Treatment of Tuberculasis of the Spine (The operative findings and results of treatment in the first twenty vases)

https://izlik.org/JA69RB53AM

Abstract

(The operative findings and results of treatment in the first twenty vases)
İn the treatment of tüberculosis of the spineevacuation of the contents of the absess, including the bone seguestra and the seğuestrated intervertebral dises, combine with removal of all avascular bone and anterior fusion with a strut graft has, in our hands, given resultsuperior to those obtained by other methods. Although, for the most part, the patients we treated had advanced disease involving many vertebrae, we have obtained our best and most gratifaying results in patients with early lesions, We should like to emphasize the fallowing points:
1 — The anterior approach gives a vide access to the disease, which is always more ekstensive than the roenigenogram would lead one to suppose.
2 — 'The removal af all avasculer bone is essential to ensure rapid, solid sound fusion.
3 — Anterior fusion by bone transplantation after a through excision of the disease focus is successful in a very high proportion Of cases.
4— Anterior fusion by this method has reduced the period of hospitallisation form years to months.
5 — İn agreement with Pott we belive that «fusion of the bodies of the vertebrae is the thing to be aimed at», fora soundiy fused spine is unlikely to be the seat of reccurent tuserculosis.

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