Posterior Yaklaşımla Uygulanan Lomber Disk Protezlerinde Füzyon Oranları

Abstract

Amaç: Cerrahi gerektiren dejeneratif disk hastalığında sadece diskektomi yapılması yeterli olduğu gibi ilgili seviyede hareketin devamlılığını koruma, nüks ve komşu seviye hastalığı gelişimini engelleme amaçları ile lomber disk protezleri kullanılabilmektedir. Bu çalışmada posterior yaklaşımla uygulanan lomber disk protezlerindeki füzyon oranları değerlendirilmiştir.

Araçlar ve Yöntem: Yozgat Bozok Üniversitesi Tıp Fakültesi Hastanesinde 1 Haziran 2016 ve 31 Ekim 2020 yılları arasında tek seviye lomber disk protezi uygulanan hastalar retrospektif olarak tarandı. Füzyon gelişiminin varlığı bilgisayarlı tomografi tetkiklerine dayanılarak konuldu. İstatiksel analizde SPSS 25 kullanıldı ki-kare ve lineer regresyon testleri yapıldı.

Bulgular: Çalışmaya toplamda 94 hasta dahil oldu. Bunların 48’i (%51) erkek 46 tanesi (%48.9) ise kadın cinsiyette idi. Lomber (L)3-4 (n=9), L4-5 (n=60) ve L5-Sakral(S)1 (n=25) seviyelerine protez uygulamasının yapıldığı belirlendi.12 (%12.7) hastada daha önce diskektomi öyküsü mevcuttu.10 (%10.6) hastada füzyon geliştiği belirlendi. Füzyon gelişim zamanının ortalama 13±6.6 ay (minimum 2-maksimum 25 ay) olduğu tespit edildi. Füzyon gelişimi ile yaş, cinsiyet, takip süresi ve eski operasyon öyküsü arasında istatiksel olarak anlamlı farklılık tespit edilmedi (sırasıyla p=0.15, p=0.20, p=0.24 ve p=0.35).

Sonuç: Posterior yaklaşımla uygulanan lomber disk protezlerinde 2 ay gibi çok kısa bir sürede ve azımsanamayacak oranda füzyon gelişebilmektedir. Füzyon gelişim oranının cinsiyet, yaş, takip süresi ve geçirilmiş diskektomi öyküsü ile ilişkisi yoktur. 

Keywords

• posterior
• lomber disk protezi
• füzyon

Fusion Rates in Lumbar Disc Prosthesis Applied by posterior approach

Abstract

Purpose: In lumbar herniation which requires surgery, only simple discectomy may be sufficient; however, lumbar disc prostheses are used to protect the continuity of movement at the relevant level and to prevent recurrence and development of adjacent level disease. In this study, the fusion rates of lumbar disc prostheses applied by posterior approach were evaluated.

Materials and Methods: Patients who underwent single-level lumbar disc prosthesis in Yozgat Bozok University School of Medicine Hospital between June 1, 2016 and October 31, 2020 were retrospectively scanned. The presence of fusion development was determined based on the computerized tomography examinations. SPSS 25 was used for statistical analysis, chi-square and linear regression tests were performed.

Results: A total of 94 patients were included in the study. 48 of them (51%) were male and 46 of them (48.9%) were female. It was determined that prosthesis was applied to Lumbar (L)3-4 (n=9), L4-5 (n=60) and L5-Sacral(S)1 (n=25) levels. 12 patients (12.7%) had a previous history of discectomy. It was determined that fusion developed in 10 (10.6%) patients. The mean fusion development time was 13±6.6 months (minimum 2-maximum 25 months). There was no statistically significant difference between fusion development and age, gender, follow-up period and previous operation history (p=0.15, p=0.20, p=0.24 and p=0.35, respectively). 

Conclusion: In lumbar disc prostheses applied posteriorly, fusion can develop at a considerable rate, even for a very short time such as 2 months. The rate of fusion development was not related to gender, age, follow-up period, and history of previous discectomy.

Keywords

• posterior
• lumbar disc prosthesis
• fusion

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