Çoklu seviye dejeneratif servikal disk hernilerinde anterior yaklaşımla bıçaklı kafes uygulaması: 156 olguluk klinik seri

Year 2019, Volume: 44 Issue: Supplement 1, 383 - 390, 29.12.2019

Emre Bilgin , Gökhan Çavuş , Ali İhsan Ökten , Yurdal Gezercan , Vedat Açık Ali Arslan , Semih Kıvanç Olguner , İsmail İştemen

https://doi.org/10.17826/cumj.563446

Abstract

Amaç: Klinik çalışmamızda multıple seviyeli servikal dejenaratif disk hernilerinde (2-4 seviye) yaş, cinsiyet, seviye sayısı, şikayet ve bulgular gözönünde bulundurularak anterior servikal diskektomi ile beraber bıçaklı cage uygulaması ve cerrahi sonrası hastaların klinik düzelmeleri, komplikasyon oranları ve radyolojik olarak değerlendirilmeleri amaçlanmıştır.

Gereç ve Yöntem: 2012-2018 yılları arasında 2,3 ve 4 seviyeli servikal dejeneratif disk hernisi tespit edilen 156 hastanın şikayet, semptom, nörolojik muayene, radyolojik bulgular ve cerrahi olarak uygulanan diskektomi ve bıçaklı kafes ile postoperatif sonuçlar ve komplikasyonlar değerlendirilmiştir.  

Bulgular: Hastaların %41.6’sı (65 hasta) erkek, %58.4’ü (91 hasta) kadındı. Yaş aralıkları 32-76 ve yaş ortalamaları 50.68’di. %85.2’si (133 hasta) iki mesafe, %13.5’i (21 hasta) üç mesafe, %1.3’ü (2 hasta) dört mesafe servikal disk hernisine sahipti. Hastaların hepsi daha önce konservatif tedavi olarak ilaç kullanmış ve %79.5’i (124 hasta) fizik tedavi görmüştü. Hastalar postoperatif 3-36 ay ortalama 18 ay izlendi. Komplikasyon olarak, postoperatif erken dönemde 5 hastada nörodefisit, 1hastada yüzeyel yara enfeksiyonu gelişti. 

Sonuç: İki ve daha fazla seviyeli servikal dejeneratif disk hernili ve spondilozlu hastalara uygulanan anterior servikal diskektomi ve bıçaklı kafes  ameliyatları ile   anterior plakla stabilizasyona gerek kalmaksızın servikal bölgenin hareketlerinin korunması sağlanabilir.

Keywords

Cervical Degenerative Disc Herniation, Anterior Discectomy

Supporting Institution

adana şehir eğitim ve araştırma hastanesi

Bladed peek cage using the anterior approach in multiple-level degenerative cervical disc herniation: a case series of 156 patients

Abstract

Purpose: This study aimed to evaluate the efficacy of cervical discectomy with bladed peek cage and differences in clinical outcomes, complication rates, and radiological findings of patients with multiple-level cervical degenerative disc herniation in terms of age, sex, and number of levels.

Materials and Methods: The following data were assessed: demographic data, patient complaints, symptoms, neurologic examination and radiologic findings, postoperative outcomes, and complications of surgery. We assessed 156 patients who had level 2, 3, and 4 cervical degenerative disc herniation detected between 2012 and 2018 via radiological examination.

Results: Of the patients, 41.6% (n = 65) were men and 58.4% (n = 91) women. The patients were aged 32–76 years, with an average age of 50.68 years. Moreover, 85.2% (n = 133), 13.5% (n = 21), and 1.3% (n = 2) of patients presented with level 2, 3, and 4 cervical degenerative disc herniation, respectively. All patients received medications as a conservative treatment during the preoperative period, and 79.5% (n = 124) underwent physiotherapy. In terms of complications, five patients developed neurological deficit and one developed superficial wound infection during the early postoperative period.

Conclusion: The fusion rate may be similar to the stabilization, and cervical region movements may be achieved after performing anterior cervical plaque surgery with cage as well as anterior cervical discectomy and bladed peek cage surgery in patients with level 2 or higher cervical degenerative disc herniation and/or cervical spondylosis.

Keywords

: Anterior discectomy, bladed cage

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