İleri derece skolyozun cerrahi tedavisinde posterior enstrümantasyon ve füzyon sonuçları
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Tarih
2018
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Maltepe Üniversitesi, Tıp Fakültesi
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CC0 1.0 Universal
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Amaç: Kliniğimizde posterior enstrümantasyonla tedavi edilen ileri derece skolyozlu olguların sonuçlarının radyolojik ve klinik açıdan değerlendirilmesi, komplikasyonların ortaya koyularak, tartışılmasıdır. Gereç ve Yöntem:2011-2018 yılları arasında ileri derece skolyoz tanısı konulmuş(80 derece ve üzerinde eğriliğe sahip) ve posterior segmental enstrumantasyon ve füzyon cerrahisi uygulanmış yeterli dökümana sahip, 38 hasta çalışmamıza dahil edilmiştir. Bu hastaların ameliyattan önce, sonra ve son kontrollerden elde edilen radyografik ve klinik muayenelerinin sonuçları retrospektif olarak değerlendirilmiştir. Bulgular: 80 derece ve üzeri skolyozu olan 38 hastanın 18' i (%47.3) bayan, 20'si(%52.7) erkektir.Hastaların ameliyata alınma yaşları 5 ile 45 arasında değişmekle birlikte ortalama 21,210 dur. Cinsiyetlerine göre dağılımlarına bakıldığında, bayanlarda yaş aralığı 5 ile 43 arasında görülmüş, ortalama 20.1 olarak bulunmuştur. Erkeklerde ise yaş dağılımı 12 ile 45 arasında olup, ortalama yaş 24 'dür.Olgular 6 ay ile 75 ay arasında takip edilmiş olup, ortalama takip süresi 24.6 aydır.Hastaların; 12'si konjenital, 8'i nöromuskuler skolyoz, 18'i ise adolesan idiopatik skolyoz hastasıydı.Vakaların 25'inde (%65.7) ana şikayet sırtta deformite olup, 13 vakada (%34.2) hipokondriyak ağrı ön planda tespit edilmiştir. Çalışmaya dahil edilen olguların 11'inde (%28.9), akciğer kapasitesinde belirgin azalma ve solunum şikayetleri mevcuttu.Olguların (n=38) operasyon öncesi cobb açı değerleri ortalama 96.8 derece iken postoperatif 46.7 derece idi.Olguların (n=38) operasyon öncesi Toraks-pelvis mesafesi ölçüm değerleri(mm)253.4 iken operasyon sonrası 317.4 mm olarak ölçüldü.Olguların (n=38) operasyon öncesi Torakal Kifoz (T5-T12)değeri ortalama 59.4 ° iken cerrahi sonrası 35.4°'ye gerilemiştir. Sonuç: İleri derce skolyozun cerrahi tedavisinde posterior enstrümentasyon ile füzyon, hasta memnuniyeti, eğriliğin düzeltilmesi ve düşük komplikasyon oranları ile etkin ve başarılı bir yöntemdir.
Objective:To evaluate radiological and clinical of the results of patients with severe scoliosis treated with posterior instrumentations in our clinic and to expose and discuss the complications. Material and Methods: Between 2011 and 2015, 38 patients diagnosed with advanced scoliosis with aduquate documentation ( having a curve of 80 degrees or more) and who underwent posterior segmental instrumentation and fusion surgery were included in our study.The results of radiographic and clinical examinations of these patients before and after the surgery and from the last controls were evaluated retrospectively. Results: Of the 38 patients with scoliosis of 80 degree curve or more, 18 (47.3%) were female and 20 (52.7%) were male. The age of patients to be operated varied between 5 and 45 and the mean is 21,210 years. In terms of gender distribution, the age range of women was between 5 and 43 old and avarage was found to be 20.1 years. In males, age distribution is between 12 and 45 and avarage is 24 years. The cases were monitored between 6 months and 75 months and the average follow-up period is 24.6 months. Twelve patients had congenital, 8 had neuromuscular scoliosis and 18 had adolescent idiopathic scoliosis. In 25 (65.7%) cases, the main complaint was deformity in the back, and in 13 (34.2%) cases hypochondriac pain was found in the foreground. Eleven (28.9%) of the patients included in the study had a significant decrease in lung capacity and respiratory complaints. The mean preoperative cobb angle was 96.8 degrees and 46.7 degrees postoperatively( n=38). Thorax-pelvic distance were measured as 253.4 mm and 317.4 mm postoperatively (n = 38). Thoracic kyphosis (T5-T12) was 59.4 ° before the operation (n = 38) and after surgery It decreased to 35.4 °. Conclusion: Posterior instrumentation, fusion, patient satisfaction, curvature correction and low complication rates are an effective and successful method in the surgical treatment of advanced scoliosis.
Objective:To evaluate radiological and clinical of the results of patients with severe scoliosis treated with posterior instrumentations in our clinic and to expose and discuss the complications. Material and Methods: Between 2011 and 2015, 38 patients diagnosed with advanced scoliosis with aduquate documentation ( having a curve of 80 degrees or more) and who underwent posterior segmental instrumentation and fusion surgery were included in our study.The results of radiographic and clinical examinations of these patients before and after the surgery and from the last controls were evaluated retrospectively. Results: Of the 38 patients with scoliosis of 80 degree curve or more, 18 (47.3%) were female and 20 (52.7%) were male. The age of patients to be operated varied between 5 and 45 and the mean is 21,210 years. In terms of gender distribution, the age range of women was between 5 and 43 old and avarage was found to be 20.1 years. In males, age distribution is between 12 and 45 and avarage is 24 years. The cases were monitored between 6 months and 75 months and the average follow-up period is 24.6 months. Twelve patients had congenital, 8 had neuromuscular scoliosis and 18 had adolescent idiopathic scoliosis. In 25 (65.7%) cases, the main complaint was deformity in the back, and in 13 (34.2%) cases hypochondriac pain was found in the foreground. Eleven (28.9%) of the patients included in the study had a significant decrease in lung capacity and respiratory complaints. The mean preoperative cobb angle was 96.8 degrees and 46.7 degrees postoperatively( n=38). Thorax-pelvic distance were measured as 253.4 mm and 317.4 mm postoperatively (n = 38). Thoracic kyphosis (T5-T12) was 59.4 ° before the operation (n = 38) and after surgery It decreased to 35.4 °. Conclusion: Posterior instrumentation, fusion, patient satisfaction, curvature correction and low complication rates are an effective and successful method in the surgical treatment of advanced scoliosis.
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Meydaneri, S. (2018). İleri derece skolyozun cerrahi tedavisinde posterior enstrümantasyon ve füzyon sonuçları / Results of posterior segmental enstrumantion and fusion surgery at severe scoliosis. (Yayımlanmamış Uzmanlık Tezi). Maltepe Üniversitesi, Tıp Fakültesi, İstanbul.
