sdü tıp fak derg Medical Journal of Süleyman Demirel University 2602-2109 Süleyman Demirel Üniversitesi GEBELİKTE BEL AĞRISI VE LOMBER DİSK HERNİSİNE YAKLAŞIM Şenol Nilgün Karaaslan Tamer 06 30 2010 17 2 31 34 01 21 2010 Copyright © 1994, Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 1994 Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Gebelerde bel ağrısı sık rastlanan bir durumdur ve hamilelik süresince kadınların yaklaşık % 56'sında bildirilmiş bir semptomdur. Buna karşılık semptom veren lomber disk hernisi oldukça nadirdir. Lomber disk hernisi ve kök basısı düşünülen olgularda tanı MRI ile konulabilir. İlerleyici nörolojik defisit veya kauda equina sendromu varsa, kalıcı hasarların önlenmesi için cerrahi gebeliğin hangi safhası olursa olsun güvenli bir şeklide uygulanabilir. Çalışmalar göstermiştir ki, gebelik süresince MRI yapılması, epidural veya genel anestezi uygulanması veya cerrahi girişim için herhangi bir kontrendikasyon yoktur.

 bel aðrýsý lomber disk hernisi gebelik Ostgaard HC, Andersson GB, Karlsson K. Prevalence of back pain in pregnancy. Spine 1991; 16(5):549-52. Hammar M, Berg G, Lillieskold U, Linden U, Thorblad J. Backache in pregnancy-occurrence, diagnosis and background factors. Lakartidningen 1986;83(21):1960- 2. Russell R, Reynolds F. Back pain, pregnancy, and childbirth. BMJ 1997; 314:1062-3. LaBan MM, Perin JCS, Latimer FR. Pregnancy and the herniated lumbar disc. Arch Phys Med Rehabil 1983;64:319-21. Ozer FA. Lomber disk hastalýðý. Ýstanbul, Logos yayýncýlýk 2000;116-142. Turk DC, Okifuji A. Assessment of patients reporting of pain: an integrated perspective. Lancet 1999;353(9166):1784-8. MacEvilly M, Buggy D. Back pain and pregnancy: a review. Pain 1996;64(3):405-14. Zileli M. Lomber disk hastalýðýnda tedavi endikasyonlarý ve hasta yönetimi. In: Zileli M, Özer FA .Omurilik ve Omurga Cerrahisi (2nd ed) Izmir, Meta Basým. 2002; 647-660. Wedenberg K, Moen B, Norling A. A prospective randomized study comparing acapuncture with physiotherapy for low-back and pelvic pain in pregnancy. Acta Obstet Gynecol Scand 2000;79(5):331- 5. Kihlstrand M, Stenman B, Nilsson S, Axelsson O. Water-gymnastics reduced the intensity of back/low back pain in pregnant women. Acta Obstet Gynecol Scand 1999;78(3):180-5. Forrester M. Low back pain in pregnancy. Acapuncture in Medicine 2003;21(1-2):36-41. Sihvonen T, Huttunen M, Makkonen M, Airaksinen O. Functional changes in back muscle activity correlate with pain intensity and prediction of low back pain during pregnancy. Arch Phys Med Rehabil 1998;79(10):1210-2. Ng J, Kitchen N. Neurosurgery and pregnancy. J Neurol N e u r o s u rg P s y c h i a t r y 2 0 0 8 ; 7 9 : 7 4 5 - 7 5 2 . Iskid AB. Gebe hastalarda ailaç seçimi. Sted 2007;16(1):15-17. Fager CA. Observations on spontaneous recovery from intervertebral disc herniation. Surg Neurol 1994;42(4):282-6. Shapiro S. Cauda equina syndrome secondary to lumbar disc herniation. Neurosurgery 1993;32:743-6. Brown MD, Levi AD. Surgery for lumbar disc herniation during pregnancy. Spine 2001;26:440-3. Kathirgamanathan A, Jardine AD, Levy DM, et al. Lumbar disc surgery in the third trimester- with the fetus in utero. Int J Obstet Anesth 2006;15:181-2. LaBan MM, Perrin JCS, Latimer FR. Pregnancy and the herniated lumbar disc. Arch Phys Med Rehabil 1983;64:319-21. Ashkan K, Casey ATH, Powell M, et al. Back pain during pregnancy and after childbirth: an unusual cause not to miss. J Royal Soc Med 1998;91:88-90. O’Laoire SA, Crockard HA, Thomas DG. Prognosis for sphincter recovery after oeration for cauda equina compression owing to lumbar disc prolapse. BMJ 1981;282:1852-4. Cunningham FG, Macdonald PC, Grant NF, et al., eds. Williams Obstetrics. 20th ed. Stamford, CT:Appleton&lange;1997;1046. Cunningham FG, Macdonald PC, Grant NF, et al., eds. Williams Obstetrics. 20th ed. Stamford, CT:Appleton&lange;1997;1054. Evans JA, Savitz DA, Kanal E, et al. Infertility and pregnancy outcome among magnetic resonance imaging workers. J Occup Med 1993;35:1191-5. Laban MM, Rapp NS, Van Oeyen P, et al: The lumbar herniated disc of pregnancy: a report of six cases identified by magnetic resonance imaging. Arch Phys Med Rehabil 1995;76:476-9. Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics. 3rd ed. New York: Churchill Livingstone; 1996;452. Relton JES, Hall JE. An operative frame for spinal fusion. J Bone Joint Surg 1967;49:327-32.