Şanser GÜL, Evren AYDOĞMUŞ, Emrah KESKİN, Bektaş AÇIKGÖZ, Murat KALAYCI, Hasan Ali AYDIN, Kenan ŞİMŞEK

Lomber Disk Cerrahisinde İnsizyon Büyüklüğünün Ameliyat Sonrası Paraspinal Adale İyileşmesine Etkisi

Amaç: Bu çalışmada subperiostal mikrodiskektomi tekniğinde daha küçük insizyon ve daha küçük ekartör kullanımının paraspinal adele iyileşmesi ve yaşam kalitesi üzerindeki etkisi araştırılmıştır. Gereç ve Yöntemler: Bu çalışma, Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı’nda lomber disk hernisi tanısı ile ameliyat edilen 100 hasta üzerinde retroprospektif olarak yapılmıştır. Çalışmada iki ayrı grup oluşturulmuş ve her iki grubun postoperatif lomber Manyetik rezonans (MR) görüntüleri karşılaştırılarak sonuca varılmıştır. Bulgular: Cerrahide kullanılan ekartörün ve insizyonun büyüklüğünün paraspinal adele atrofisi üzerinde istatistiksel olarak anlamlı şekilde etkisinin olduğu gözlenmiştir (p < 0.001). Sistemik hastalığı olan hastalarda ekartör ve insizyonun büyüklüğünün paraspinal kas atrofisi üzerinde istatistiksel olarak anlamlı şekilde etkisinin olmadığı gözlemiştir (p = 0.052). Sonuç: Bu çalışmada mikrodiskektominin küçük retraktör ve küçük insizyon kullanılarak yapılmasının paraspinal kas atrofisi gelişmesinin en aza indirilebilmiş olması, kas dokusu üzerinde koruyucu etkileri olduğunu işaret etmektedir.

The Effect of Incision Size in Lumbar Disc Surgery on Post-operative Paraspinal Muscle Healing

Aim: In this study, the effect of the use of smaller incision and smaller retractor in subperiosteal microdiscectomy technique on muscle healing and quality of life is investigated. Material and Methods: This retrospective study is conducted on 100 patients who underwent surgery with the diagnosis of lumbar disc herniation in Zonguldak Bülent Ecevit University, School of Medicine, Department of Neurosurgery. In this study, two groups were formed and result was obtained by comparing the postoperative lumbar MR images of the two groups. Results: It was observed that the size of the retractor used in surgery and the size of the incision had a statistically significant effect on paraspinal muscular atrophy (p < 0.001). It was observed that the size of the retractor and incision had no statistically significant effect on paraspinal muscle atrophy in patients with systemic disease (p = 0.052). Conclusion: In this clinical study, the minimization of muscle atrophy suggests that performing microdiscectomy with small retractor and small incision has muscle tissue protective properties.

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