LOMBER OMURGA ENSTRÜMANTASYONUNUN OMURGA AÇILARINA ETKİSİ

Yıl 2022, Cilt: 8 Sayı: 3, 56 - 67, 31.12.2022

Şamil Dikici Ali Serdar Oğuzoğlu Nilgün Şenol Cengiz Gazeloğlu Murat Goksel

Öz

Giriş: Bu çalışmamız Süleyman Demirel Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Nöroşirürji Kliniği’nde Nisan 2017 – Nisan 2018 tarihleri arasında opere edilmiş olan 80 hastanın operasyon öncesi ve sonrası sonuçları değerlendirilerek hazırlanmıştır.
Amaç: Farklı patolojiler sebebiyle posterior stabilizasyon ve füzyon operasyonu geçiren hastalara uygulanan iki farklı füzyon yönteminin postoperatif süreçte omurga açılarına etkisinin araştırılmasıdır.
Materyal ve Method: Çalışmada transpediküler vida ile posterior stabilizasyon ve füzyon yapılan (40 hasta) ve bu yöntemin interbody cage ile desteklenerek füzyon yapılan (40 hasta) toplam 80 hasta retrospektif olarak incelenmiştir. Hastaların ameliyat öncesi, ameliyat sonrası 1. ay ve ameliyat sonrası 1. yıl lomber lordoz açıları ve L4-5 wedge açıları ölçülerek açılar arasındaki değişimlerin yüzdelik değerleri hesaplanmış, bulunan değerler SPSS paket programı ve T testi kullanılarak istatistiksel olarak hesaplanmıştır.
Sonuç: Çalışmamız interbody kafes ile desteklenmiş olan hastaların omurga açılarına daha olumlu katkıları olduğunu göstermektedir.

Anahtar Kelimeler

Spinal enstrümantasyon, lomber lordoz açısı, L4-5 kama açısı, transpediküler vida, interbody kafes

THE EFFECT OF LUMBAR SPINE INSTRUMANTATION ON SPINE ANGLES

Öz

Introduction: This study was performed by evaluating the preoperative and postoperative results of 80 patients who underwent surgery at Neurosurgery Clinic of Süleyman Demirel University Medical Faculty Hospital, between April 2017 and April 2018.
Purpose: The purpose of the present study was to evaluate the effect of two different surgical lomber spinal fusion methods on selected spinal angle measurements in the early & late postoperative periods.
Material and Method: In the present study, a total of 80 patients 40 of whom underwent posterior stabilization and fusion with transpedicular screw (40 patients), and 40 of whom were supported with fusion and interbody cage (40 patients) were examined retrospectively. The preoperative, postoperative 1st month and 1st year postoperative lumbar lordosis angles and L4-5 wedge angles were measured on computerized tomography (CT) scans of the patients. The percentages of the changes in these angles were calculated. The results were compared by using t test with SPSS program.
Result: Our study means a positive contribution of interbody cage application to reach the goal of preserving spinal angles as close as possible to the normal ranges post-operatively.

Anahtar Kelimeler

Spine instrumentation, lumbar lordosis angle, L4-5 wedge angle, transpedicular screw, interbody cage

Kaynakça

• 1) Sonntag VKH: History of spinal disorders. In: Menezes AH and Sonntag VKH (ed.s.): Principles of spinal surgery. McGraw-Hill, New York, 1996, Pp 3-23
• 2) Hadra B.E. Wiring the spinous processes in Pott’s disease. Trans Am Orthop Assoc 4:206-210,1891
• 3) Carl AL, Tranmer BI, Sachs BL. Anterolateral dynamized instrumentation and fusion for unstable thoracolumbar and lumbar burst fractures. Spine 22; 686-690, 1997.
• 4) Pappas CTE, Sonntag VKH. Lumbar stenosis in the elderly. Neurosurgery Quarterly 4; 102-112, 1994.
• 5) Farfan HF, Kirkaldy-Willis WH. The present status of spinal fusion in the treatment of lumbar intervertebral joint disorders. Clin Orthop 158; 198-214, 1981.
• 6) Freerickson BE, Baker D, McHolick WJ, et al. The natural history of spondylolisis and spondylolisthesis. JBone Joint Surg Am 66; 699-707, 1984.
• 7) Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med 211; 210-214, 1934.
• 8) Marchesi DG, Aebi M. Pedicle fixation devices in the treatment of adult lumbar scoliosis. Spine 17; 304-309, 1992.
• 9) Lynch MC, Taylor JF. Facet joint injection for low back pain. A clinical study. J Bone Joint Surg Br 68; 138-141, 1986.
• 10) Been E, Barash A, Marom A, Kramer PA. Vertebral Bodies or Discs Which Contributes More to Human-like Lumbar Lordosis?  Clin Orthop Relat Res DOI 10.1007/s11999-009-1153-7
• 11) Pearcy MJ, Portek I, Shepherd J. Three dimensional X-ray analysis of normal movement in the lumbar spine 1984;
• 12) Stefan Gödde, MD, Ekkehard Fritsch, MD, Michael Dienst, MD, and Dieter Kohn, MD. Influence of cage geometry on sagittal alignment in instrumented posterior lumbar interbody fusion. Spine, Vol 28, number 15;1693-1699, 2003.
• 13) Stonecipher T, Wright S. Posterior lumbar interbody fusion with facet-screw fixation. Spine (Phila Pa 1976) 1989; 14:468-471 [PMID: 2718053]
• 14) Lee CS, Hwang CJ, Lee DH, Kim YT, Lee HS. Fusion rates of instrumented lumbar spinal arthrodesis according to surgical approach: a systematic review of randomized trials. Clin Orthop Surg 2011; 3: 39-47 [PMID: 21369477 DOI: 10.4055/cios.2011.3.1.39]
• 15) Klemme WR, Owens BD, Dhawan A, Zeidman S, Polly DW. Lumbar sagittal contour after posterior interbody fusion:threaded devices alone versus vertical cages plus posterior instrumentation. Spine (Phila Pa 1976) 2001; 26: 534-537 [PMID: 11317974]
• 16) Barrey CY, Boissiere L, D’Acunzi G, Perrin G. One-stage combined lumbo-sacral fusion, by anterior then posterior approach: clinical and radiological results. Eur Spine J 2013; 22 Suppl 6: S957-S964 [PMID: 24048651 DOI: 10.1007/s00586-013-3017-9]
• 17) Suk S-I, Lee C-K, Kim W-J, et al: Adding posterior lumbar interbody fusion to pedicle screw fixation and posterolateral fusion after decompression in spondylolytic spodylolisthesis. Spine 22; 210-219, 1997.