Destandau Tekni̇ğiyle Lomber Diskektomi̇ Kısa Vadede Daha İyi Sonuçlar Veri̇yor

Öz

Amaç: Desdandau tekniği (EDDT) ve standart açık teknik (SOD) kullanılarak lomber diskektomi yapılan has-taların uzun dönem sonuçları karşılaştırıldı. Materyal ve Metod: 2007-2011 yılları arasında tek seviyeli lomber diskektomi yapılan 18-70 yaş arası has-talar retrospektif olarak tarandı. Toplam 52 hasta çalışma kriterlerini karşıladı ve kullanılan cerrahi tekniğe göre EDDT grubu (n:27) ve SOD grubu (n:25) olmak üzere 2 gruba ayrıldı. Tüm hastalar Görsel Analog Skala (GAS), Oswestry Engellilik İndeksi (ODI) ve modifiye MacNab kriterleri kullanılarak karşılaştırıldı. Bulgular: Ortalama takip süresi EDDT grubunda 158.2±9.2 ay, SOD grubunda 161.2±11.1 ay olarak hesaplandı. Ameliyat öncesi VAS ve ODI değerlerinin her iki grupta da benzer olduğu görüldü (sırasıyla p=0.829; p=0.120). Ameliyat sonrası erken dönemde VAS ve ODI değerleri EDDT grubunda daha düşüktü (VAS: EDDT: 2.2±0.6; SOD: 4.1±0.8, p<0.001; ODI: EDDT: 15.4±1.6, SOD: 29.1±1.9, p<0. 001, sırasıyla), ancak son kontrolde iki grup arasında VAS ve ODI skorlarında anlamlı bir fark yoktu (VAS: EDDT: 2.1±0.4, SOD: 2.4±0.5, p=0.078; ODI: EDDT: 14.6±2.1, SOD: 15.1±1.2, p=0.033, sırasıyla). Modifiye MacNab kriterlerine göre, SOD grubunun %88'inde ve EDDT grubunun %92'sinde iyi ve mükemmel sonuçlar elde edildi. Sonuç: Çalışmada her iki tekniğin uzun dönem sonuçları benzer bulunmuştur. Ancak Destandau tekniğinin erken dönem sonuçları daha iyiydi. Endoskopik yöntem günlük aktivitelere erken dönüş açısından daha iyi görünmektedir.

Anahtar Kelimeler

• Destandau tekniği
• açık diskektomi
• endoskopik diskektomi
• lomber disk hernisi

Destandau Tekni̇ğiyle Lomber Diskektomi̇ Kısa Vadede Daha İyi Sonuçlar Veri̇yor

Öz

Background: The long-term results of patients who underwent lumbar discectomy using the Desdandau technique (EDDT) and standard open technique (SOD) were compared. Materials and Methods: A retrospective screening was made of patients, aged 18-70 years, who underwent single-level lumbar discectomy between 2007 and 2011. A total of 52 patients met the study criteria and were separated into 2 groups according to the surgical technique used, the EDDT group (n: 27) and the SOD group (n:25). All patients were compared using Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and modified MacNab criteria. Results. The mean follow-up period was calculated as 158.2±9.2 months in the EDDT group and 161.2±11.1 months in the SOD group. The preoperative VAS and ODI values were observed to be similar in both groups (p=0.829); p=0.120 respectively). At the early postoperative visit, VAS and ODI values were lower in the EDDT group (VAS: EDDT: 2.2±0.6; SOD: 4.1±0.8, p<0.001; ODI: EDDT: 15.4±1.6, SOD: 29.1±1.9, p<0.001, respectively), however, there was no significant difference in VAS and ODI scores between the two groups at the last control (VAS: EDDT: 2.1±0.4, SOD: 2.4±0.5, p=0.078; ODI: EDDT: 14.6±2.1, SOD: 15.1±1.2, p=0.033, respectively). According to the modified MacNab criteria, good and excellent results were obtained in 88% of the SOD group and 92% of the EDDT group. Conclusion: The study found that the long-term results of both techniques were similar. However, the Destandau technique had better early results. The endoscopic method seems to be better in terms of early return to daily activities.

Anahtar Kelimeler

• Destandau technique
• open discectomy
• endoscopic discectomy
• lumbar disc herniation

Kaynakça

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