Lomber Disk Hernisi Nedeniyle Düşük Ayak Gelişen Hastalarda Semptomların Başlangıcından Ameliyata Kadar Geçen Sürenin Prognoza Etkisi

Amaç: Bu çalışmanın amacı, düşük ayak gelişiminden sinir dekompresyonuna kadar geçen sürenin düşük ayak kliniğinde iyileşme oranı ve derecesi üzerine olan etkilerini değerlendirmektir.Gereç ve Yöntemler: Nisan 2014 ve Şubat 2019 arasında düşük ayak kliniği (ayak bileği dorsifleksiyonu 0/5 parazik) nedeniyle mikrodiskektomi geçirmiş olan ardışık 30 hasta retrospektif olarak incelendi. Hastalar düşük ayak gelişiminden ameliyata kadar geçen süreye göre <72 saat, 72 saat ile 1 hafta ve >1 hafta olmak üzere göre 3 gruba ayrıldı. Gruplar arasında ameliyat sonrası ayak bileği dorsifleksiyon kas kuvvetlerinin iyileşme oranlarını ve derecesini değerlendirmek için Kruskal-Wallis ve Bonferroni düzeltmeli Mann Whitney U testi kullanıldı.Bulgular: Bu çalışmada, düşük ayak nedeniyle ameliyat edilen 30 hasta (18 kadın ve 12 erkek) değerlendirilmiştir. Hastaların ameliyat sırasındaki ortalama yaşı 46,5±13,5 (aralık 18-72) idi. Ameliyat sonrası ayak bileği dorsifleksiyonu kas gücü <72 saat grubunda 4,2±1,6 (aralık, 0-5), 72 saat - 1 hafta grubunda 1,7±1,6 (aralık, 0-5) ve >1 hafta grubunda 1,0±1,3 (aralık, 0-3) idi. <72 saat grubunun ameliyat sonrası kas gücü iyileşme seviyesi hem 72 saat - 1 hafta grubundan (p=0,003) hem de >1 hafta grubundan (p=0,002) anlamlı şekilde farklılık göstermekteydi. 72 saat - 1 hafta grubu ve >1 hafta grubu arasında istatistiksel olarak anlamlı bir farklılık görülmedi (p=0,427).Sonuç: Düşük ayak kliniğinde semptomların başlangıcından cerrahi dekompresyona kadar geçen sürenin, ameliyat sonrası iyileşme oranlarında istatistiksel olarak anlamlı bir prediktör olduğu görüldü.

Anahtar Kelimeler:

Düşük ayak, lomber disk hernisi, cerrahi, prognoz

The Effect of Time Elapsed from the Onset of Symptoms to Surgery on Prognosis in Patients with Foot Drop due to Lumbar Disc Hernia

Aim: The aim of this study was to evaluate the effect of the duration from foot drop development to nerve decompression on the rate and degree of recovery in foot drop clinic.Material and Methods: We retrospectively reviewed 30 consecutive patients who had undergone microdiscectomy for foot drop clinic (ankle dorsiflexion 0/5 paresis) between April 2014 and February 2019. Patients were divided into three groups according to the time from foot drop development to surgery, as <72 hours, 72 hours to 1 week, and >1 week. Kruskal-Wallis and Bonferroni corrected Mann Whitney U test were used to evaluate the rate and degree of recovery of ankle dorsiflexion muscle strength between groups.Results: In this study, 30 patients (18 females and 12 males) who underwent surgery for foot drop were evaluated. Mean age at the time of surgery was 46.5±13.5 (range, 18-72) years. Postoperative ankle dorsiflexion strength was 4.2±1.6 (range, 0-5) in <72 hours group, 1.7±1.6 (range, 0-5) in 72 hours - 1 week group and 1.0±1.3 (range, 0-3) in >1 week group. Postoperative muscle strength improvement level of <72 hours group was significantly different both from 72 hours - 1 week group (p=0.003) and from >1 week group (p=0.002). There was no statistically significant difference between 72 hours - 1 week group and >1 week group (p=0.427).Conclusion: In foot drop clinic, the duration from onset of symptoms to surgical decompression was a statistically significant predictor of postoperative recovery rates.

Keywords:

Foot drop, lumbar disc hernia, surgery, prognosis,

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