Black Disc During Lumbar Spinal Surgery: Two Case Reports with Ochronosis

Abstract

Ochronosis is a disease that shows autosomal recessive transition that develops due to homogenistic acid oxidase enzyme deficiency and progresses with the accumulation of HA metabolites in connective tissues. It is characterized by a gray-black pigmentation in the tissues. This accumulation is more common especially in connective tissues. The most affected segment is the lumbar region in the spine. Homogenistic acid and its metabolites accumulate at disc distance, causing narrowing at disc distance, calcifications and instability in the intervertebral disc. It should be kept in mind in the differential diagnosis of lumbar spondylosis in younger cases. In our study, 2 ocronotic cases with lumbar involvement were presented. Especially in the 2nd case, the effects of accumulation on spondylotic disruption in lumbar spine segment were clearly seen. Studies with larger patient series are needed to prevent the development of spondylosis in ocronotic cases and to develop effective treatment methods.

Keywords

• ochronosis
• lumbar
• black disc

Lomber Omurga Cerrahisi Sirasinda Siyah Disk: Okronozisli İki Olgu Sunumu

Abstract

Okronozis, homojenistik asit oksidaz enzim eksikliğine bağlı olarak gelişen ve bağ dokularında HA metabolitlerinin birikmesi ile ilerleyen otozomal çekinik geçiş gösteren bir hastalıktır. Dokularda gri-siyah pigmentasyon ile karakterizedir. Bu birikim özellikle bağ dokularında daha sıktır. En çok etkilenen segment omurgadaki lomber bölgedir. Homojenistik asit ve metabolitleri disk mesafesinde birikerek disk mesafesinde daralmaya, kalsifikasyonlara ve intervertebral diskte instabiliteye neden olur. Daha genç olgularda lomber spondiloz ayırıcı tanısında akılda tutulmalıdır. Çalışmamızda lomber tutulumu olan 2 adet okronozisli olgu sunuldu. Özellikle 2. olguda lomber omurga segmentinde birikimin spondilotik bozulma üzerindeki etkileri net olarak görüldü. Okronozisli olgularda spondiloz gelişimini önlemek ve etkin tedavi yöntemleri geliştirmek için daha geniş hasta serili çalışmalara ihtiyaç vardır.

Keywords

• OKRONOZİS
• SİYAH DİSK
• lomber

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