Lomber Mikrodiskektomi Olgularının Tuffier Çizgi Seviyelerine Göre Dağılımı

Year 2023, , 194 - 198, 30.04.2023

Ali Akar , Ümit Ali Malçok

https://doi.org/10.54005/geneltip.1229507

Abstract

Amaç: Lomber disk hernisinin (LDH) cerrahi tedavisinde en sık kullanılan yöntem, lomber mikrodiskektomidir (LMD). Bu çalışma ile, lomber spinal girişimlerde L4-5 mesafesini tespit edilmesinde yaygın olarak kullanılan Tuffier’s çizgisi (TL) ile LMD seviyeleri arasındaki ilişkiyi göstermeyi amaçladık.
Gereç ve yöntem: Bu çalışmada, LMD yapılan veya bel ağrısı şikayeti olan toplam 204 hasta retrospektif olarak incelendi. TL seviyesinin omurga düzeyindeki izdüşümüne göre; L4 korpus, L4 alt endplate, L4-5 disk aralığı, L5 üst endplate, L5 korpus olmak üzere 5 kategoriye ayrıldı. Olgular yaş, cinsiyet, disk seviyesi ve TL seviyesindeki değişimlere göre analiz edildi.
Bulgular: Olguların % 92.1’i L4-5 veya L5-S1 seviyesinden opere edilmişti. TL seviyesi, kadınlarda sıklıkla L5 üst endplate seviyesinde iken erkeklerde L4-5 disk aralığı ve üstünde idi ve TL seviyeleri ile cinsiyet arasında her iki grupta da anlamlı bir ilişki mevcuttu (p<0.05).
Sonuç: Çalışmamızda, TL seviyeleri, L5-S1 seviyesinden opere edilen hastalarda kaudalde olmasına karşın, L4-5 seviyesinde opere edilenlerde kraniale doğru yer değiştirdiğini tespit ettik. Bununla birlikte, LDH gelişiminin alt lomber bölgeden başladığı ve yaşın ilerlemesi ile birlikle üst seviyelerde arttığı görüldü.

Keywords

Tuffier çizgisi, Lomber disk hernisi, Lomber mikrodiskektomi

Distribution of Lumbar Microdiscectomy Cases by Tuffier’s Line Levels

Abstract

Objective: The most used method in the surgical treatment of lumbar disc herniation (LDH) is lumbar microdiscectomy (LMD). In this study, we aimed to show the relationship between Tuffier's line (TL), which is widely used in determining the L4-5 distance in lumbar spinal interventions, and LMD levels.
Materials and Methods: In this study, a total of 204 patients who had LMD or had low back pain were reviewed retrospectively. According to the projection of TL at the spine level; it was divided into 5 categories as L4 corpus, L4 lower endplate, L4-5 disc space, L5 upper endplate, L5 corpus. The cases were analyzed according to age, gender, disc level and changes in TL.
Results: 92.1% of the cases were operated at the L4-5 or L5-S1 level. TL was mostly at L5 upper endplate level in women, L4-5 disc space and above in men, and there was a significant relationship between TLs and gender in both groups (p<0.05).
Conclusion: In our study, we found that although TLs were caudally in patients operated at L5-S1 level, they displaced cranially in patients operated at L4-5 level. However, it was observed that LDH development in the lower lumbar region and increased at the upper levels with ageing.

Keywords

Tuffier, Lumbar disc herniation, Lumbar microdiscectomy, Tuffier çizgisi, Lomber disk hernisi, Lomber mikrodiskektomi

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