Anterior servikal diskektomi ve füzyon yapılan hastaların klinik ve radyolojik bulgularının pre/postoperatif dönemlerde retrospektif olarak değerlendirilmesi

Abstract

Amaç: Servikal disk hernilerinde altın standart tedavi yöntemi olarak kabul edilen anterior servikal diskektomi ve içi demineralize kemik matriks ile dolu polyether-ether-ketone (PEEK) kafes ile füzyon uygulanan hastaların cerrahi sonuçları değerlendirilerek, günümüzde popüler olan disk artroplastisi gibi cerrahi tekniklerle literatür taraması eşliğinde karşılaştırılmıştır.
Gereç ve yöntem: Ağustos 2011 ile Nisan 2015 tarihleri arasında opere edilen 347 hastanın, retrospektif olarak yapılan nörolojik muayenelerinin, klinik bulgularının, ağrı ve yaşam kalitesi skalaları ve 142 hastanın pre/postoperatif radyolojik bulguları değerlendirilmiştir.
Bulgular: Hastaların ortalama yaşı 46,7±9,4 (min 23-maks 75), 165’i (%47,6) erkek, 182’si (%52,4) kadın olarak tespit edilmiştir. Tek seviye diskektomi ve füzyon yapılan 229 hasta (%66); iki seviye diskektomi ve füzyon yapılan 112 hasta (%32,3); 3 seviye diskektomi ve füzyon yapılan 6 hasta (%1,7) olarak tespit edilmiştir. Hastaların ortalama takip süreleri 16±11,7 aydır (min3 ay-maks 46 ay). Toplam 14 (%4) hastada postoperatif komplikasyon tespit edilmiş olup bunlardan sadece ikisinde (kozalji ve motor güç kaybı olan hastalar) şikayetler tam olarak düzelme göstermemiştir.
Sonuç: Çalışmamız, servikal disk hastalığının tedavisinde eski ve yeni birçok yöntemle karşılaştırıldığında, ASDF yönteminin günümüzde altın standart tedavi olduğunu desteklemektedir. Gerek klinik skalalar gerekse radyolojik kriterler göz önüne alındığında yüksek hasta memnuniyeti, etkinlik ve güvenlik sağladığı görülmektedir

Keywords

• Servikal diskektomi
• PEEK kafes
• Servikal aks

Retrospective evaluation of clinical and radiological findings of patients who underwent anterior cervical discectomy and fusion in pre/postoperative periods

Abstract

Purpose: The surgical results of patients who underwent anterior cervical discectomy, which is accepted as the gold standard treatment method in cervical disc hernia, and fusion with polyether-ether-ketone (PEEK) cage filled with demineralized bone matrix, were evaluated and compared with today's popular surgical techniques such as disc arthroplasty, accompanied by a literature review.
Materials and methods: Retrospective neurological examinations, clinical findings, pain, and quality of life scales of 347 patients operated between August 2011 and April 2015, and pre/postoperative radiological findings of 142 patients were evaluated.
Results: The mean age of the patients was 46.7±9.4 (min 23-max 75), 165 (47.6%) male, 182 (52.4%) female. Two hundred twenty-nine patients (66%) underwent single-level discectomy and fusion; 112 patients (32.3%) underwent two-level discectomy and fusion; six patients (1.7%) underwent three levels of discectomy and fusion. The mean follow-up period of the patients was 16±11.7 months (min 3 months-max 46 months). Postoperative complications were detected in a total of 14 (4%) patients, and only two of them (patients with causalgia and loss of motor power) did not show complete improvement.
Conclusion: Our study supports that the anterior cervical discectomy and fusion method is currently the gold-standard treatment compared with many old and new methods in treating cervical disc disease. Considering both clinical scales and radiological criteria, ASDF provides high patient satisfaction, efficacy, and safety.

Keywords

• Cervical discectomy
• PEEK cage
• cervical axis

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