Comparison of two types of surgery for lumbar spinal stenosis in elderly: decompressive laminectomy with and without fusion

Yıl 2020, Cilt: 6 Sayı: 1, 54 - 58, 23.04.2020

Tayfun Çakır , Şeyho Cem Yücetaş

https://doi.org/10.30569/adiyamansaglik.649416

Öz

Aim: To compare decompressive total laminectomy with and without instrumented fusion.

Materials and Methods: 54 patients who underwent decompression formed the group 1, and 48 patients who underwent decompression plus fusion formed group 2. Patients were compared in terms of age, sex, body mass index, duration of surgery, length of hospital stay, visual analog scale (VAS) and oswestry disability index (ODI) scores and complications.

Results: No significantly differences about age, sex, body mass index (BMI), length of hospital stay were found between the groups. There was significant difference between the groups about mean operative times (p<0.05). In both of the groups VAS scores improved significantly. In both groups there was statistically significant decrease in ODI values. And second surgery requirement was significantly higher in the group 2 (p<0.01).

Conclusion: Facet protective decompression surgery performed up to two levels can be successfully terminated without fusion.

Anahtar Kelimeler

Spinal, Stenosis, Laminectomy, Fusion, Elderly

Yaşlılarda lomber spinal stenoz için iki tip cerrahinin karşılaştırılması: füzyonlu ve füzyonsuz dekompresif laminektomi

Öz

Amaç: Lomber spinal stenoz cerrahisinde füzyonlu ve füzyonsuz dekompresif laminektomi yapılan hastaların 3 yıl sonundaki klinik bulgularını ve komplikasyon oranlarını karşılaştırmak.

Gereç ve Yöntem: Grup 1'de tek başına dekompresyon uygulanan 54 hasta, grup 2'de ise dekompresyon ve posterior transpediküler füzyon uygulanan 48 hasta vardı. Ameliyat süresi, hastanede kalış süresi, yaş, cinsiyet, vücut kitle indeksi gibi özellikler değerlendirildi. Hastaların vizüel ağrı skalası (VAS), oswestry disability index (ODI) skorlarında değişim ve komşu segment sendromu gibi komplikasyon oranları karşılaştırıldı.

Bulgular: Yaş, cinsiyet, vücut kitle indeksi (VKİ) ve hastanede kalış süresi açısından anlamlı bir farklılık yoktu ama ameliyat süresi açısından anlamlı fark vardı (p<0,05). İki grupta da VAS ve ODI açısından anlamlı şekilde iyileşme gözlendi. Grup 2'de 3 yıllık süreç içerisinde ikinci cerrahi gereksinimi daha yüksekti (p<0,01).

Sonuç: İki seviyeye kadar yapılan dekompresyon cerrahisinin füzyon gerektirmeden başarıyla yapılabileceği sonucuna vardık.

Anahtar Kelimeler

Spinal, Stenoz, Laminektomi, Füzyon, Yaşlılık

Kaynakça

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