PERKÜTAN LAZER DİSK DEKOMPRESYONUNUN KISA VE UZUN DÖNEM SONUÇLARI: RETROSPEKTIF BİR COHORT ÇALIŞMA

Year 2025, Volume: 26 Issue: 2, 140 - 147, 28.04.2025

Alper Ergin , Hasan Kamil Sucu , Selin Bozdağ

https://doi.org/10.18229/kocatepetip.1502773

Abstract

AMAÇ: Disk içindeki basıncın azaltılmasının, fıtıklaşmış disklerde sinir kökü basıncından kaynaklanan siyataljiyi ve bazı durumlarda diskojenik bel ağrısını iyileştirdiği rapor edilmiştir. Perkütan lazer disk dekompresyonu, disk hacmini (nükleus pulposus) azaltmak için kullanılan perkütan yöntemler arasında yer almaktadır. Yazarlar, lomber disk hernisi olan semptomatik hastalarda perkütan lazer disk dekompresyonunun etkilerini sunmayı amaçladılar.
GEREÇ VE YÖNTEM: L4-L5 disk herniasyonuna bağlı bel ve/veya bacak ağrısı şikayeti olan hastaların perkütan lazer disk dekompresyonu öncesinde Vizuel Analog Skala (VAS) ve Oswestry Engellilik İndeksi (ODI) kullanılarak klinik değerlendirmeleri yapıldı. Ameliyat sonrası 2. saatte erken VAS değerleri kaydedildi. Ayrıca operasyondan 1 ve 3 ay sonra ODI ve VAS kullanılarak klinik değerlendirme yapıldı. VAS değerleri ameliyat öncesine göre 10 üzerinden 2 puan veya daha fazla azalan hastaların işlemden fayda gördüğü kabul edildi. Uzun dönem sonuçlar için de en az 10 yıllık takipte ODI ve hasta tatmininin değerlendirilmesi için üçlü likert ölçeği kullanıldı.
BULGULAR: Kliniğimizde 21 L4-L5 perkütan lazer disk dekompresyonu uygulandı. Perkütan lazer disk dekompresyonunun başarı oranı, VAS değerlerindeki düşüşe göre ilk üç ay için %90,0 ve Oswestry Engellilik İndeksine göre on yıllık dönem için %72,73 olarak hesaplanmıştır.
SONUÇ: Başarı oranları, bu prosedürle hastalarda kısa ve uzun dönemde iyi sonuçlara ulaşıldığını göstermektedir. Bu tekniğin avantajları arasında kullanım kolaylığı ve ayaktan tedavi olarak uygulanabilmesi sayılabilir.

Keywords

Fıtıklaşmış disk, Lumbar vertebra, Omurga, Perkütan, Lazer cerrahisi.

Ethical Statement

Etik Onay: Çalışma için İzmir Katip Çelebi Üniversitesi Etik Kurulu'ndan 0119 sayılı karar ile onay alınmıştır.

Supporting Institution

Yok

Thanks

Yok

SHORT AND LONG-TERM RESULTS OF PERCUTANEOUS LASER DISC DECOMPRESSION: A RETROSPECTIVE COHORT STUDY

Abstract

OBJECTIVE: Decreasing intradiscal pressure has been reported to improve sciatica, caused by nerve root pressure in herniated discs and improve discogenic low back pain in some cases. Percutaneous laser disc decompression is among percutaneous methods to decrease the disc volume (nucleus pulposus). The authors aimed to present the effects of the percutaneous laser disc decompression on symptomatic patients with lumbar disc hernia.
MATERIAL AND METHODS: The clinical assessments of the patients s with complaints of low back and/or leg pain due to L4-L5 disc herniation were performed using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) before percutaneous laser disc decompression. Early VAS values were recorded in the 2nd hour after surgery. Also, a clinical evaluation was performed using the ODI and VAS both 1 and 3 months after the procedure. The patients whose VAS values decreased by 2 points or more (out of 10) compared to the preoperative period were determined to have benefited from the procedure for these periods. For the long-term outcomes, ODI was used for at least 10 years of follow-up, and the triple Likert scale was used to evaluate patient satisfaction.
RESULTS: Twenty-one L4-L5 percutaneous laser disc decompressions were performed in our clinic. The success rate of percutaneous laser disc decompression was determined to be 90.0% for the first three months based on the decrease in VAS values and 72.73% over a ten year period, according to the ODI.
CONCLUSIONS: The success rates show that this procedure has achieved promising results for patients in both the short and long term. The advantages of this technique include the ease of use and its applicability as an outpatient procedure.

Keywords

Herniated disc, Lumbar vertebrae, Spine, Percutaneous, Laser surgery.

Ethical Statement

Ethical Approval: The approval for the study was obtained from The Ethics Committee of Izmir Katip Celebi University, under decision number 0119.

Supporting Institution

None

Thanks

None

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