SERVİKAL MİYELOPATİLİ HASTALARDA UNİLATERAL YAKLAŞIM İLE BİLATERAL DEKOMPRESYONUN KLİNİK SONUÇLARI

Year 2018, Volume: 20 Issue: 3, 313 - 320, 30.12.2018

Mustafa Öğden , Süleyman Akkaya , Ulaş Yüksel Ahmet Turan Dağlı , Bülent Bakar , Mehmet Faik Özveren

https://doi.org/10.24938/kutfd.473716

Cited By: 1

Abstract

Amaç: Servikal omurgadaki kemik ve ligamentöz yapıların dejeneratif
değişiklikleri spinal kanal darlığına ve spinal kord basısına yol açmaktadır.
Posterior destek sağlayan kas, ligament gibi yapıların korunarak, unilateral
yaklaşım ile bilateral dekompresyon (UYBD) giderek yaygın olarak
uygulanmaktadır. Bu çalışmada, unilateral yaklaşım ile bilateral dekompresyon
cerrahi tekniği kullanılarak tedavi edilen servikal spondilotik myelopatili
(SSM) hastalarda, bu yöntemin etkinliğini değerlendirmeyi amaçladık.

Gereç ve Yöntem: SSM tanısıyla unilateral yaklaşım ile
bilateral dekompresyon tekniği ile opere edilen hastaların verileri
retrospektif olarak incelendi. Hastaların yaş, cinsiyet, operasyon öncesi ve 1
yıl sonrası ağrı şiddetini gösteren vizüel analog skala (VAS) değerleri ile
OSWESTRY Disabilite İndeksi (ODİ) değerleri kayıt edildi.

Bulgular: Çalışmamıza yaşları 41 ile 77 arasında değişen
(ortalama 60.23±9.5 yıl) toplam 13 hasta dahil edildi. Hastaların %76.9’u erkek
idi. Tedavi sonrası VAS ve ODİ değerleri karşılaştırıldığında tedavi sonrası değerlerde
istatistiksel olarak anlamlı bir iyileşme görüldü (p=0.001).

Sonuç: Çalışmamızda SSM’li hastalarda unilateral yaklaşım
ile bilateral dekompresyon cerrahisiyle başarılı sonuçlar elde edilmiştir.
SSM’li hastalarda henüz az sayıda çalışmada unilateral yaklaşım ile bilateral
dekompresyon tekniği ile tedavinin etkinliği değerlendirilmiş olduğu dikkate
alındığında, bu çalışmada elde ettiğimiz sonuçlar bundan sonraki çalışmalara
ışık tutacaktır.

Keywords

Servikal spinal stenoz, servikal spondiloz, servikal disk hernisi, spinal dekompresyon

Clinical Results of Bilateral Decompression with Posterior Unilateral Approach in Patient with Cervical Myelopathy

Abstract

Objective: Degenerative changes in bone and ligamentous structures in
the cervical spine lead to spinal canal stenosis and spinal cord compression.
Bilateral decompression with unilateral approach is increasingly being applied
with preserving structures such as muscles and ligaments that provide posterior
support. The aim of this study was to evaluate the efficacy of this method in
patients with cervical sponylotic myelopathy (CSM) who were treated using bilateral
decompression with unilateral approach surgical technique.

Material and Method: The data of patients who had CSM and were
operated using bilateral decompression with unilateral approach technique were
retrospectively reviewed. Demographical features such as age, gender were
noted. Preoperative and postoperative (first year) pain severity were evaluated
using Visual analogue Scale (VAS) ​​and OSWESTRY Disability Index (ODI).

Results: A total of 13 patients aged between 41 and 77 years (mean 60.23±9.5
years) were included. 76.9% of the patients were male. When post-treatment VAS
and ODI values ​​were compared, there was a statistically significant
improvement in post-treatment values ​​(p=0.001).

Conclusion:
In our study, successful results were obtained with bilateral
decompression with unilateral approach in CSM patients. Considering that the
efficacy of the treatment with bilateral decompression with unilateral approach
technique has been assessed in a small number of CSM patients, the results
obtained in this study will encourage further studies.

Keywords

Cervical spinal stenosis, cervical spondylosis, cervical disc hernia, spinal decompression

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