KOKSİDİNİA’LI OLGULARDA CERRAHİ TEDAVİ VE SONUÇLARI

Amaç: Bu çalışmada koksidinia tanısı konmuş, fakat konservatif tedaviye dirençli olgularda koksikseksizyonunun sonuçlarını literatür bilgileri ışığında değerlendirmeyi amaçladık.Gereç ve Yöntem: 2011 ile 2016 yılları arasında opere edilmiş 29 hasta çalışmaya dahil edildiBu hastaların 24’ü kadın, 5’i erkekti. Tüm hastalar aynı cerrah tarafından opere edildi. Etioloji,yakınmaların süresi, preoperatif ve postoperatif ağrı düzeyi, Postacchini-Massobrio sınıflandırmasınagöre derecesi, ve sonrasında ortaya çıkan kompilikasyonlar değerlendirildi.Bulgular: Koksidinia hastalarının 8 tanesinin gebelik sonrası, 9 tanesinin kalça üzerine düşmenedeniyle, 8 hasta direk travma ve sert zemin üzerine uzun süre oturma sonrası oluştuğu tespitedildi. Hastalarımızın 4 tanesinde ise sebep bulunamadı. Yapılan analiz sonucunda preoperatifve postoperatif vizuel ağrı skalası (VAS) düzeylerinin hastalarda anlamlı olarak farklılaştığı belirlendi.Sonuç: Koksiks ağrısının tedavisinde konservatif yöntemler başarı ile uygulanmaktadır. Fakatkonservatif tedaviden fayda görmeyen vakaların cerrahi tedavi ile düzeltilebileceği göz önündebulundurulmalıdır.

Surgical Treatment Outcomes in Patients with Coccydynia

Objective: The aim of the study was to evaluate the outcomes of coccyx excision in coccydynia patients resistant to conservative treatment under the light of literature data. Material and Method: Twenty nine patients (24 females and 5 males) who underwent operation between 2011 and 2015 were included in the study. All patients were operated by the same surgeon. The patients were evaluated according to regard to etiology, duration of complications, pre- and post-operative pain severity, score of Postacchini-Massobrio classification and post-operative complications. Results: Patients with coxdynia; 8 cases were found after pregnancy, 9 cases were due to fall on the hip, 8 cases were due to direct trauma and after sitting on hard ground for a long time. No reasons could be detected in 4 patients. Pre-operative and post-operative visual analogue scale (VAS) levels were detected to significantly differ. In the evaluation of microcalcifications, moderate agreement (κ = 0.59) for number, good agreement (κ = 0.68) for morphology and excellent agreement (κ = 0.89) for distribution were detected between the DM and DMT examinations. Conclusion: Conservative methods are successfully applied in treatment of coccyx pain however surgical treatment should be considered in patients those who do not benefit from conservative treatment.

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