Lomber diskojenik ağrıya neden olanspinal gaz birikimi: Olgu sunumu

Öz

Vakum disk fenomeni, sıklıkla dejeneratif disk hastalıklarıyla birlikte görülen ve disk aralığında gaz birikimi ile karakterize bir durumdur. Disk aralığında gaz birikiminin klinik önemi olmasa da, spinal kanal içinde görüldüğünde klinik bulgulara yol açabilir. Çalışmamızda, kliniğimize başvurmadan önce 3 aydır bel ve sol bacak ağrısı olan 60 yaşındaki bir bayan hasta sunuyoruz. Hastanın sol bacak germe testi 50 derecede pozitifti. Manyetik rezonans görüntülemede vakum disk fenomeni ile birlikte L5-S1 disk aralığının daraldığı ve T1 ve T2 ağırlıklı görüntülerde hipointens kistik kitle görüldü. Hasta ameliyata alındı ve sol L5-S1’e hemilaminektomi ve foraminotomi uygulandı. Sinir kökü ve duraya yapışık olan kist duvarı kısmi olarak eksize edildi. Hasta ameliyat sonrası ilk günde ağrısızdı. Spinal kanalda gaz birikimi diskojenik ağrıya yol açabilir. Spinal kanalda gaz birikimi ile birlikte vakum disk fenomeninde cerrahi tedavi hala uygulanabilir bir yöntemdir.

Anahtar Kelimeler

• Gaz birikimi; siyatik; spinal kanal; vakum fenomeni.

Spinal gas accumulation causing lumbar discogenic disease: a case report

Öz

Vacuum disc phenomenon is seen frequently with degenerative disc disease and is characterized by the collection of gas in the disc space. Although the accumulation of gas within the disc space does not have clinical significance, symptoms may develop when occurring within the spinal canal. We present a 60-year-old female patient with low back and left leg pain occurring for 3 months before admission to our clinic. Straight leg raise test was 50 degrees in the left leg. Magnetic resonance imaging showed a narrowing of the L5-S1 disc space with vacuum disc phenomenon and hypointense cystic mass in T1 and T2-weighted images. The decision for surgery was made and left L5-S1 hemilaminectomy and foraminotomy was performed. The cyst wall was adherent to the root and dura mater and was partially excised. The patient was pain-free on the first postoperative day. In cases of gas accumulation in the spinal canal, discogenic pain may occur. Surgical therapy is still an acceptable method for the treatment of vacuum disc phenomenon and accumulation of gas within the spinal canal.

Anahtar Kelimeler

• Gas accumulation
• sciatica
• spinal canal
• vacuum phenomenon

Kaynakça

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