Alçı veya Korse ? Torakolomber Vertebra Kırıklarında İki Konservatif Yöntemin Uzun Dönem Klinik ve Radyolojik Sonuçları

Yıl 2025, Cilt: 15 Sayı: 3, 309 - 316, 15.09.2025

Halil Gök , Alim Can Baymurat

Öz

Amaç: Torakolomber vertebral kompresyon kırıklarının konservatif tedavisinde hiperekstansiyon alçısı ile Jewett breysinin uzun dönem klinik ve radyolojik sonuçlarını değerlendirmek ve karşılaştırmaktır.
Yöntemler: 2002-2012 yılları arasında T10 ile L2 arasında stabil kompresyon kırığı tanısı alan ve hiperekstansiyon alçısı (Grup A) veya Jewett breysi (Grup B) ile konservatif olarak tedavi edilen hastalar retrospektif olarak incelendi. Ağrı düzeyleri Görsel Analog Skala (VAS), fonksiyonel durum Oswestry Engellilik İndeksi (ODI), kifoz açısı Cobb yöntemi ile değerlendirildi.
Bulgular: Toplam 35 hasta çalışmaya dahil edildi (Korse grubu: n = 18; Alçı grubu: n = 17). Gruplar arasında yaş, cinsiyet, KMY indeksi veya takip süresi açısından istatistiksel olarak anlamlı bir fark yoktu (p > 0.05). Ancak, hastanede kalış süresi alçı grubunda anlamlı derecede daha uzundu (2,1 ± 0,68 güne karşı 1,1 ± 0,52 gün; p < 0,001). Alçı grubunda kifotik deformitenin ilerlemesi daha sınırlı olmuştur (p = 0.042). Hiçbir majör komplikasyon gözlenmemiştir. Korse grubunda daha erken mobilizasyon sağlandı.
Sonuçlar: Jewett breysi erken mobilizasyon ve fonksiyonel iyileşme açısından avantaj sağlayabilirken, hiperekstansiyon alçısı zaman içinde kifotik ilerlemeyi sınırlamada daha etkili görünmektedir.

Anahtar Kelimeler

: Torakolomber Kırık , Hiperekstansiyon Alçısı , Jewett Korsesi , Konservatif Tedavi , Kifotik Açı

Casting or Bracing? Long-Term Clinical and Radiological Outcomes of Two Conservative Modalities in Thoracolumbar Vertebral Fractures

Öz

Objective: To evaluate and compare the long-term clinical and radiological outcomes of hyperextension casting versus Jewett bracing in the conservative management of thoracolumbar vertebral compression fractures.
Methods: Patients diagnosed with stable compression fractures between T10 and L2 who were treated conservatively with either hyperextension casting (Group A) or Jewett bracing (Group B) between 2002 and 2012 were retrospectively reviewed. Pain levels were assessed using the Visual Analog Scale (VAS), functional status via the Oswestry Disability Index (ODI), kyphotic angle by the Cobb method, and patient satisfaction was also recorded.
Results: A total of 35 patients were included (Brace group: n = 18; Cast group: n = 17). There were no statistically significant differences between groups in terms of age, sex, BMD index, or follow-up duration (p > 0.05). However, hospital stay was significantly longer in the cast group (2.1 ± 0.68 days vs. 1.1 ± 0.52 days; p < 0.001). The progression of kyphotic deformity was more limited in the cast group (p = 0.042). No major complications were observed. Earlier mobilization was achieved in the brace group.
Conclusion: While the Jewett brace may offer an advantage in terms of early mobilization and functional recovery, hyperextension casting appears to be more effective in limiting kyphotic progression over time.

Anahtar Kelimeler

Thoracolumbar Fracture; , Hyperextension Cast , Jewett Brace , Conservative Treatment , Kyphotic Angle

Kaynakça

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