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Yıl 2014, Cilt: 4 Sayı: 3, 7 - 13, 03.12.2014

H. Çağdaş Basat Tarık Yazar

Öz

Objective: Comparison between the clinical and radiological findings in patients that underwent surgery due to thoracolumbar fractures was aimed in this study. Methods: Between 1995 and 2009, 38 patients (15 male, 23 female, mean age 46.5 years) that underwent operation after diagnosis of thoracolumbar fractures were admitted to the study. Clinic values were evaluated with Visual Analog Scale (VAS) and Frankle and scale of Oswestry scales. Radiological values were evaluated with preoperative, postoperative and last control X-ray images. Value of sagittal index (SI), value of local kyphosis angle (LKA) and the percentage of anterior corpus height loss (ACHL) were measured using X-ray images.Results: The mean follow-up period was 96.5months, the mean VAS value was 13,5 mm, and the mean Oswestry value was 15. Preoperative SI angles increased, as well as final control measurements. On the other hand the final control measurements became higher as postoperative angles increased (P<0,05). We also observed increased LKA, postoperative LKA and measured angle of the final controls (P<0,05). Preoperative ACHL percentage, postoperative ACHL percentage, and the ACHL percentage at the final control were all significantly higher (P<0,05). However, there was no significant correlation between the clinical and the radiological parameters.Conclusion: As a result, clinical data were not associated with radiological data.

Anahtar Kelimeler

Sagittal index; Local kyphosis angle; Anterior corpus height loss Visual analog painscale

Kaynakça

  • Eastlack RK, Bono CM. Fractures and dislocations of the thoracolumbar spine. In: RW, Heckman JD, Court-Brown CM (Eds.).Rockwood and Green’s Fractures in Adults. Vol. 2, 5th Ed. Philadelphia: Lippincott Williams Wilkins, 2001. p.1543-80.
  • Robertson A, Branfoot T, Barlow IF, Giannoudis PV. Spinal injury patterns resulting from car and motorcycle accidents. Spine. 2002; 27(24): 2825-30.
  • Gertzbein S. Scoliosis Research Society. Multicentre spine fracture study. Spine. 1992; 17(5): 528-40.
  • Benson DR. Thoracolumbar fractures, with emphasis on the burst fracture. Clinical Orthopedics and Related Research. 1988; 230(1): 14-29.
  • Denis F. The three columns of the spine and its significance in the classification of the acute thoracolumbar spine injuries. Spine. 1983; 8(1): 817-31.
  • DeWald RL. Burst fractures of the thoracic and lumbar spine. Clinical Orthopedics and Related Research. 1984; 189(1): 150-61.
  • Akalın S, Kış M, Benli İT, Çıtak M, Mumcu EF, Tüzüner M. Result of the AO spinal internal fixator in the surgical treatment of the thoracolumbar burst fractures. Eur Spine J. 1994; 3(2): 102 – 6.
  • Benli İT, Tandoğan NR, Kış M, Tüzüner M, Mumcu EF, Akalın S, Çıtak M. Cotrel –Dubousset instrumentation in the treatment of unstable thoracic and lumbar spine fractures. Arch Orthop Trauma Surg.1994;113(2): 88–92.
  • Kallemeier PM, Beaubien BP, Buttermann GR, Polga DS, Wood RB. In vitro analysis of anterior and posterior fixation in an experimental unstable burst fracture model. J Spinal Disord Tech. 2008; 21 (3): 216 – 24.
  • Knop C, Fabian H, Bastian L, Blauth M. Late results of thoracolumbar fractures after posterior instrumentation and transpedicular bone grafting. Spine. 2001; 26 (1): 88-9.
  • Marco RA, Kushwaha VP. Thoracolumbar burst fractures treated with posterior decompression and pedicle screw instrumentation supplemented with balloon – assisted vertebroplasty and calcium phosphate reconstruction. J Bone Joint Surg. 2009; 91(1): 20–8.
  • Mariotti AJ, Dwan AD. Current concepts in anterior surgery for thoracolumbar trauma. Orthop Clin North Am. 2002; 33(2): 403 – 12.
  • McLain RF, Burkus JK, Benson DR. Segmental instrumentation for thoracic and thoracolumbar fractures: prospective analysis constructs survival and five – year follow. Spine J. 2001; 1 (5): 310 – 23.
  • Sasani M, Ozer AF. Single – stage posterior corpectomy and expandable cage placement for treatment of thoracic or lumbar burst fractures. Spine. 2009; 34 (1): 33 – 40.
  • Scholl BM, Theiss SM, Kirkpatrick JS. Short segment fixation of thoracolumbar burst fractures. Orthopaedics. 2006; 29 (8): 703 –8.
  • Vaccaro AR, Kim DH, Brodke DS, Harris M, Chapman J, Schildhauer T, et al. Diagnosis and Management of Thoracolumbar Spine Fractures. An Instructional Course Lecture, American Academy of Orthopaedic Surgeons. J Bone Joint Surg Am. 2003; 85(1): 2455-70.
  • Zdeblick TA, Sasso RC, Vaccaro AR, Chapman JR, Harris MB. Surgical treatment of thoracolumbar fractures. Instr Course Lect. 2009; 58(1): 639 –44.
  • Bohlman HH. Treatment of fractures and dislocations of the thoracic and lumbar spine. J Bone Joint Surg. 1985; 67(1): 165-9.
  • Butt MF, Farooq M, Mir B, Dhar AS, Hussain A, Mumtaz M. Management of unstable thoracolumbar spinal injuries by posterior short segment spinal fixation. Int Orthop. 2007; 31 (2): 259 – 64.
  • Davies WE, Morris JH, Hill V. An analysis of conservative (non-surgical) management of thoracolumbar fractures and fracture-dislocations with neural damage. J Bone Joint Surg. 1980; 62(1): 1324-8.
  • Hazel WA, Jones RA, Morrey BF, Stauffer RN. Vertebral fractures without neurological deficit. A long-term follow-up study. J Bone Joint Surg. 1988; 70(1): 1319-21.
  • Weinstein JN, Collalto P, Lehmann TR. Thoracolumbar “burst” fractures treated conservatively: a long-term followup. Spine. 1988; 13(1): 33-8.
  • Arlet V, Omdorff DG, Jagunnathan J, Domont A. Reverse and pseudo reverse cortical sing in thoracolumbar burst fracture: radiologic description and distinction – a propos of three cases. Eur Spine J. 2009; 18(2): 282–7.
  • Denis F, Armstrong GW, Searls K, Matta L. Acute thoracolumbar burst fractures in the absence of neuralgic defisit. A comparison between operative and non-operative treatment. Clinical Orthopedics and Related Research. 1984;189(1):1-9.
  • Shen WJ, Liv TJ, Shen YS. Non operative treatment versus posterior fixation for thoracolumbar junction burst fractures without neurologic defisit. Spine. 2001; 26 (9): 1038 –45.
  • Kraemer WJ, Schemitsch EH, Lever J, McBroom RJ, McKee MD, Waddell JP. Functional outcome of thoracolumbar burst fractures without neurological deficit. J Orthop Trauma. 1996; 10(8): 541-4.
  • Oner FC, Van Gils AP, Dhert WJ, Verbout AJ. MRI findings of thoracolumbar spine fractures: a categorization based on MRI examinations of 100 fractures. Skeletal Radiol. 1999; 28(8): 433-43.
  • Tezer M, Erturer R E, Öztürk Ç, Öztürk İ, Kuzgun Ü. Conservative treatment of fractures of the thoracolumbar spine. Intern Orthop. 2005; 29(2): 78-82.
  • Krag MH, Beynnon BD, Pope MH. An internal fixation for posterior application to short segments of the thoracic, lumbar or lumbosacral spine. Clin Orthop Relat Res. 1986; 203(1): 75-98.
  • Saifuddin A. MRI of acute spinal trauma. Skeletal Radiol. 2001; 30(5): 237-46.
  • Yazar T, Acar B. Yatay konumlu konvansiyonel MRG’de aksiyel kompresyon ve traksiyon uygulaması omurga değerlendirimesi için anlamlı mıdır? The Journal of Turkish Spinal Surgery. 2009; 20 (4): 11-8.
  • Andress HJ, Braun H, Helmberger T, Schürmann M, Hertlein H, Hartl WH. Long-term results after posterior fixation of thoracolumbar burst fractures. Injury Int J Care Injured. 2002;33(4): 357-65.
  • Farcy J-PC, Weidenbaum M, Glassman SD. Sagital index in management of thoracolumbar burst fractures. Spine. 1990; 15 (9): 958-65.
  • McNamara MJ, Stephens GC, Spengler DM. Transpedicular short-segment fusions for treatment of lumbar burst fractures. J Spinal Disorders. 1992; 5(2): 183-7.
  • Toyone T, Tanaka T, Kato D, Kaneyama R, Otsuka M. The treatment of acute thoracolumbar burst fractures with transpedicular intracorporeal hydroxyapatite grafting following indirect reduction and pedicle screw fixation: A prospective study. Spine. 2006; 31 (7): 208-14.
  • Kerwin AJ, Frykberg ER, Schinco MA, Griffen MM, Arce CA, Nguyen TQ, et al. The Effect of Early Surgical Treatment of Traumatic Spine Injuries on Patient Mortality. Journal of Trauma-Injury Infection & Critical Care. 2007; 63(6): 1308

CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI

Yıl 2014, Cilt: 4 Sayı: 3, 7 - 13, 03.12.2014

H. Çağdaş Basat Tarık Yazar

Öz

Amaç: Torokolomber omurga kırığı tanısı ile cerrahi uygulanan hastaların klinik ve radyolojik sonuçlarının
karşılaştırılması amaçlanmıştır.
Gereç ve Yöntemler: Çalışma, 1995 ile 2009 tarihleri arasında torokolomber omurga kırığı tanısı
ile cerrahi uygulanan 38 (23 kadın, 15 erkek, ortalama yaş 46.5) hastadan oluşmaktadır. Klinik
veriler Visual Analog Skala (VAS), Oswestry ve Frankel skalaları ile; radyolojik veriler ise hastaların
cerrahi öncesi, sonrası ve son kontrollerindeki çekilen X-ray görüntülerinde yapılan sagital indeks
(Sİ) değerleri, lokal kifoz açıları (LKA) ve anterior korpus yükseklik kaybı (AKYK) yüzdeleri ölçülerek
değerlendirilmiştir.
Bulgular: Hastaların ortalama takip süresi 96,5 ay (6-183 ay) dır. VAS ortalaması 13,5 mm, Oswestry
ortalaması 15’tir. Ameliyat öncesi Sİ açıları arttıkça son kontrol açıları da yükselmekte ve
ameliyat sonrası açılar ne kadar yüksekse son kontrol açıları da aynı oranda yüksek olmaktadır
(P < 0,05). LKA arttıkça ameliyat sonrası LKA da yükselmekte, ameliyat sonrası LKA arttıkça son kontrol
açısı da yüksek olmaktadır (P < 0,05). Ameliyat öncesi AKYK yüzdesi arttıkça ameliyat sonrası
AKYK yüzdesi yükselmekte; ameliyat öncesi AKYK yüzdesi arttıkça son kontrol AKYK yüzdesi yüksek
olmakta; ameliyat sonrası AKYK yüzdesi yüksekse son kontrol AKYK yüzdesi de yüksek olmaktadır
(P < 0,05).Ancak klinik sonuçlar, radyolojik parametreler ile karşılaştırıldıklarında aralarında istatistiksel
olarak anlamlı bir ilişki saptanmamıştır.
Sonuç: Sonuç olarak, klinik veriler radyolojik parametreler arasında anlamlı bir ilişki saptanmamıştır

Anahtar Kelimeler

Omurga kırıkları Sagittal indeks Lokal kifoz açısı anterior korpus yükseklik kaybı Görsel analog ağrı skalası

Kaynakça

  • Eastlack RK, Bono CM. Fractures and dislocations of the thoracolumbar spine. In: RW, Heckman JD, Court-Brown CM (Eds.).Rockwood and Green’s Fractures in Adults. Vol. 2, 5th Ed. Philadelphia: Lippincott Williams Wilkins, 2001. p.1543-80.
  • Robertson A, Branfoot T, Barlow IF, Giannoudis PV. Spinal injury patterns resulting from car and motorcycle accidents. Spine. 2002; 27(24): 2825-30.
  • Gertzbein S. Scoliosis Research Society. Multicentre spine fracture study. Spine. 1992; 17(5): 528-40.
  • Benson DR. Thoracolumbar fractures, with emphasis on the burst fracture. Clinical Orthopedics and Related Research. 1988; 230(1): 14-29.
  • Denis F. The three columns of the spine and its significance in the classification of the acute thoracolumbar spine injuries. Spine. 1983; 8(1): 817-31.
  • DeWald RL. Burst fractures of the thoracic and lumbar spine. Clinical Orthopedics and Related Research. 1984; 189(1): 150-61.
  • Akalın S, Kış M, Benli İT, Çıtak M, Mumcu EF, Tüzüner M. Result of the AO spinal internal fixator in the surgical treatment of the thoracolumbar burst fractures. Eur Spine J. 1994; 3(2): 102 – 6.
  • Benli İT, Tandoğan NR, Kış M, Tüzüner M, Mumcu EF, Akalın S, Çıtak M. Cotrel –Dubousset instrumentation in the treatment of unstable thoracic and lumbar spine fractures. Arch Orthop Trauma Surg.1994;113(2): 88–92.
  • Kallemeier PM, Beaubien BP, Buttermann GR, Polga DS, Wood RB. In vitro analysis of anterior and posterior fixation in an experimental unstable burst fracture model. J Spinal Disord Tech. 2008; 21 (3): 216 – 24.
  • Knop C, Fabian H, Bastian L, Blauth M. Late results of thoracolumbar fractures after posterior instrumentation and transpedicular bone grafting. Spine. 2001; 26 (1): 88-9.
  • Marco RA, Kushwaha VP. Thoracolumbar burst fractures treated with posterior decompression and pedicle screw instrumentation supplemented with balloon – assisted vertebroplasty and calcium phosphate reconstruction. J Bone Joint Surg. 2009; 91(1): 20–8.
  • Mariotti AJ, Dwan AD. Current concepts in anterior surgery for thoracolumbar trauma. Orthop Clin North Am. 2002; 33(2): 403 – 12.
  • McLain RF, Burkus JK, Benson DR. Segmental instrumentation for thoracic and thoracolumbar fractures: prospective analysis constructs survival and five – year follow. Spine J. 2001; 1 (5): 310 – 23.
  • Sasani M, Ozer AF. Single – stage posterior corpectomy and expandable cage placement for treatment of thoracic or lumbar burst fractures. Spine. 2009; 34 (1): 33 – 40.
  • Scholl BM, Theiss SM, Kirkpatrick JS. Short segment fixation of thoracolumbar burst fractures. Orthopaedics. 2006; 29 (8): 703 –8.
  • Vaccaro AR, Kim DH, Brodke DS, Harris M, Chapman J, Schildhauer T, et al. Diagnosis and Management of Thoracolumbar Spine Fractures. An Instructional Course Lecture, American Academy of Orthopaedic Surgeons. J Bone Joint Surg Am. 2003; 85(1): 2455-70.
  • Zdeblick TA, Sasso RC, Vaccaro AR, Chapman JR, Harris MB. Surgical treatment of thoracolumbar fractures. Instr Course Lect. 2009; 58(1): 639 –44.
  • Bohlman HH. Treatment of fractures and dislocations of the thoracic and lumbar spine. J Bone Joint Surg. 1985; 67(1): 165-9.
  • Butt MF, Farooq M, Mir B, Dhar AS, Hussain A, Mumtaz M. Management of unstable thoracolumbar spinal injuries by posterior short segment spinal fixation. Int Orthop. 2007; 31 (2): 259 – 64.
  • Davies WE, Morris JH, Hill V. An analysis of conservative (non-surgical) management of thoracolumbar fractures and fracture-dislocations with neural damage. J Bone Joint Surg. 1980; 62(1): 1324-8.
  • Hazel WA, Jones RA, Morrey BF, Stauffer RN. Vertebral fractures without neurological deficit. A long-term follow-up study. J Bone Joint Surg. 1988; 70(1): 1319-21.
  • Weinstein JN, Collalto P, Lehmann TR. Thoracolumbar “burst” fractures treated conservatively: a long-term followup. Spine. 1988; 13(1): 33-8.
  • Arlet V, Omdorff DG, Jagunnathan J, Domont A. Reverse and pseudo reverse cortical sing in thoracolumbar burst fracture: radiologic description and distinction – a propos of three cases. Eur Spine J. 2009; 18(2): 282–7.
  • Denis F, Armstrong GW, Searls K, Matta L. Acute thoracolumbar burst fractures in the absence of neuralgic defisit. A comparison between operative and non-operative treatment. Clinical Orthopedics and Related Research. 1984;189(1):1-9.
  • Shen WJ, Liv TJ, Shen YS. Non operative treatment versus posterior fixation for thoracolumbar junction burst fractures without neurologic defisit. Spine. 2001; 26 (9): 1038 –45.
  • Kraemer WJ, Schemitsch EH, Lever J, McBroom RJ, McKee MD, Waddell JP. Functional outcome of thoracolumbar burst fractures without neurological deficit. J Orthop Trauma. 1996; 10(8): 541-4.
  • Oner FC, Van Gils AP, Dhert WJ, Verbout AJ. MRI findings of thoracolumbar spine fractures: a categorization based on MRI examinations of 100 fractures. Skeletal Radiol. 1999; 28(8): 433-43.
  • Tezer M, Erturer R E, Öztürk Ç, Öztürk İ, Kuzgun Ü. Conservative treatment of fractures of the thoracolumbar spine. Intern Orthop. 2005; 29(2): 78-82.
  • Krag MH, Beynnon BD, Pope MH. An internal fixation for posterior application to short segments of the thoracic, lumbar or lumbosacral spine. Clin Orthop Relat Res. 1986; 203(1): 75-98.
  • Saifuddin A. MRI of acute spinal trauma. Skeletal Radiol. 2001; 30(5): 237-46.
  • Yazar T, Acar B. Yatay konumlu konvansiyonel MRG’de aksiyel kompresyon ve traksiyon uygulaması omurga değerlendirimesi için anlamlı mıdır? The Journal of Turkish Spinal Surgery. 2009; 20 (4): 11-8.
  • Andress HJ, Braun H, Helmberger T, Schürmann M, Hertlein H, Hartl WH. Long-term results after posterior fixation of thoracolumbar burst fractures. Injury Int J Care Injured. 2002;33(4): 357-65.
  • Farcy J-PC, Weidenbaum M, Glassman SD. Sagital index in management of thoracolumbar burst fractures. Spine. 1990; 15 (9): 958-65.
  • McNamara MJ, Stephens GC, Spengler DM. Transpedicular short-segment fusions for treatment of lumbar burst fractures. J Spinal Disorders. 1992; 5(2): 183-7.
  • Toyone T, Tanaka T, Kato D, Kaneyama R, Otsuka M. The treatment of acute thoracolumbar burst fractures with transpedicular intracorporeal hydroxyapatite grafting following indirect reduction and pedicle screw fixation: A prospective study. Spine. 2006; 31 (7): 208-14.
  • Kerwin AJ, Frykberg ER, Schinco MA, Griffen MM, Arce CA, Nguyen TQ, et al. The Effect of Early Surgical Treatment of Traumatic Spine Injuries on Patient Mortality. Journal of Trauma-Injury Infection & Critical Care. 2007; 63(6): 1308
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Orjinal Çalışma
Yazarlar

H. Çağdaş Basat

Tarık Yazar Bu kişi benim

Yayımlanma Tarihi 3 Aralık 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 4 Sayı: 3

Kaynak Göster

APA Basat, H. Ç., & Yazar, T. (2014). CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI. Bozok Tıp Dergisi, 4(3), 7-13.
AMA Basat HÇ, Yazar T. CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI. Bozok Tıp Dergisi. Aralık 2014;4(3):7-13.
Chicago Basat, H. Çağdaş, ve Tarık Yazar. “CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI”. Bozok Tıp Dergisi 4, sy. 3 (Aralık 2014): 7-13.
EndNote Basat HÇ, Yazar T (01 Aralık 2014) CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI. Bozok Tıp Dergisi 4 3 7–13.
IEEE H. Ç. Basat ve T. Yazar, “CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI”, Bozok Tıp Dergisi, c. 4, sy. 3, ss. 7–13, 2014.
ISNAD Basat, H. Çağdaş - Yazar, Tarık. “CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI”. Bozok Tıp Dergisi 4/3 (Aralık 2014), 7-13.
JAMA Basat HÇ, Yazar T. CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI. Bozok Tıp Dergisi. 2014;4:7–13.
MLA Basat, H. Çağdaş ve Tarık Yazar. “CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI”. Bozok Tıp Dergisi, c. 4, sy. 3, 2014, ss. 7-13.
Vancouver Basat HÇ, Yazar T. CERRAHİ UYGULANAN TORAKOLOMBER VERTEBRA KIRIKLARINDA KLİNİK VE RADYOLOJİK SONUÇLARIN KARŞILAŞTIRILMASI. Bozok Tıp Dergisi. 2014;4(3):7-13.
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