LOMBER DEJENERATİF HASTALIKLARDA LOMBER TRANSFORAMİNAL KORPUSLAR ARASI FÜZYON(TLIF) KAFESLERİNİN ANTERİORA DOĞRU YERLEŞTİRİLMESİ; RETROSPEKTİF ANALİZ

Amaç: Tek merkezde lomber dejeneratif hastalıklarda uygulanan lomber korpuslar arası füzyon kafeslerinin(TLIF) anteriora (anterior longtdiunal ligamanı geçmiş şekilde) yerleştirilme sebeplerini ve oranlarını tanım-lamak.Yöntemler: 2014 -2017 yılları arasında 270 hasta ve bu hastaların 366 disk mesafesine uygulanan TLIF kafesuygulaması incelendi. TLIF için uygulanan kafeslerin boyutuna ve uygulanış yerlerine göre erken operasyonsonrası dönemde anterior yerleştirme oranlarına ve nedenlerine bakıldı.Bulgular: Buna göre anteriora yerleştirme toplamda 3 hastada görüldü. Anteriora yerleştirme oranı tek mer-kezli yapılan bu çalışmada %0.008 civarındadır. Bunlardan üçünde de anteriora yerleştirme seviyesinin L5-S1seviyesi olduğu görüldü.Bu hastalarda ve diğer hastalarda kullanılan kafeslerin boyutları da ele alındı. Boyutlar ele alındığında 3hastada da disk mesafesinin ön arka çapının orta noktasının sagittal görüntüdeki yüksekliğinin kafes yüksek-liğinden daha fazla olduğu görüldü.Sonuç: L5-S1 seviyesi diskin ön yüksekliği diğer disk mesafelerine göre daha fazla olduğu için burada kafesinanteriora yerleştirilmesi olasılığı yüksektir. Bunu da diskin orta noktasındaki sagittal boyutundan daha büyükbir kafes kullanılması önleyebilir.Disk mesafesinin anteroposterior çapının orta noktasında geçen disk yüksekliğinin boyutundan daha küçükbir boyuta sahip kafes uygulamasının, anteriora yerleşimi için bir risk olacağı sonucuna varılmıştır.

Anterior Misplacement of Lumbar Transforaminal Interbody Fusion (TLIF) Cages in Lumbar Degenerative Disc Disease: A retrospective Analysis

Aim: The aim of this study was to define the anterior misplacement rates and causes of lumbar transforaminal interbody fusion (TLIF) cages applied in spinal degenerative diseases in a single center Material-Method: Between 2014 and 2017, 366 intervertebral disc spaces in 270 patients which underwent TLIF cages application were evaluated. The anterior misplacement rates and causes of cages applied for fusion were assessed according to the size and location. All patients had lumbar degenerative diseases. Cage were performed in all cases where instability was obvious or the foraminal height should be increased. Peroperative scopy or early postoperative images were evaluated in the evaluation of anterior misplacement. Postoperative computed tomography (CT) was performed in all patients. The dimensions of the cages used in these patients and other patients were also discussed. Results: According to this, anterior misplacement was seen in 3 patients in total. It was seen that the level of misplacement was L5-S1 level in these three patients. Anterior misplacement rate is nearly 0.008% in this study which carried out in a single center. Conclusion: Since the frontmost height of the L5-S1 disc space is wider than the other disc spaces, the cage is more likely to be applied in a misplacement location. Application of a larger cage than the sagittal height of the midpoint of disc space can also prevent this. It was concluded that a cage application with a smaller size than the size of height of the disc space crossing at the midpoint of anteroposterior diameter of the disc space would be a risk for anterior misplacement.

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