Lomber Diskektomi Operasyonu Yapılan Hastalarda Sentetik Kollajen Membran Kullanımının Epidural Fibrozis Gelişimini Önleme Üzerine Etkilerinin MRG Bulguları ile Değerlendirilmesi

Özet Arkaplan/Amaç: Lomber diskektomi yapılan hastalarda dura mater üzerine yerleştirilen sentetik kollajen membranın araknoidit ve fibrozis gelişimini önlemedeki etkisinin manyetik rezonans görüntüleme (MRG) bulguları ile değerlendirilmesi. Yöntemler: Lomber disk hernisi nedeniyle tek seviyeli unilateral diskektomi uygulanan toplam 40 hasta retrospektif olarak değerlendirildi. Dura üzerine kollajen membran yerleştirilmiş 16 hasta ve dura üzerinde herhangi bir materyal bulunmayan 24 hasta çalışmaya dahil edildi. Kollajen membranı olan ve olmayan hastaların ameliyat sonrası MR görüntüleri incelenerek kullanılan malzemenin araknoidit ve/veya epidural fibrozis ve granülasyon dokusu oluşumunu önlemede etkili olup olmadığı değerlendirildi. Bulgular: 24 hastanın 9'u kadın (%37,5) ve 15'i erkek (%62,5) kollajen membransız gruptaydı. Kollajen membran grubundaki hastaların dördü (%25) kadın, 12'si (%75) erkekti. Membransız grubun yaş ortalaması 35,47 ± 9,06, membranlı grubun yaş ortalaması 37,40 ± 8,92 idi. MRG bulgularına göre kollajen membranlı 16 hastanın 8'inde (%50) granülasyon dokusu ve epidural fibrozis izlenmezken, 8 (%50) hastada granülasyon dokusu görüldü. Kollajen membranı olmayan 24 hastanın 10'unda (%41,7) granülasyon dokusu izlenmezken, 14'ünde (%58,3) epidural fibrozis ve granülasyon dokusu oluşumu gözlendi. Bu sonuçlara göre tip I kollajen membran kullanımı ile granülasyon dokusu oluşumu arasında istatistiksel olarak anlamlı bir ilişki bulunmadı. (P = 0,604 <0,05). Tip-I kollajen membranı olan hastalarda granülasyon dokusu (%50) ve yokluğu (%50) arasında fark yoktu. Sonuç: Bu sonuçlara ve MRG bulgularına göre, lomber diskektomide peroperatif tip-I kollajen membran kullanımının granülasyon dokusu veya epidural fibrozis oluşumu üzerinde istatistiksel olarak anlamlı bir etkisinin olmadığı bulundu.

Anahtar Kelimeler:

lomber disk hernisi, epidural fibrozis, kollajen membran, MRG

The Assessment of the Effects of Synthetic Collagen Membrane Use on the Prevention of Epidural Fibrosis Development in Patients Undergoing Lumbar Discectomy by Magnetic Resonance Imaging Findings

Abstract Bacground/Aims: The aim of study to evaluate the effects of synthetic collagen membrane placed on dura mater on the prevention of arachnoiditis and fibrosis development by magnetic resonance imaging (MRI) findings in patients undergoing lumbar discectomy. Methods: A total of 40 patients who underwent single level unilateral discectomy for lumbar disc hernia were retrospectively evaluated. Sixteen patients with collagen membranes placed on the dura and 24 patients without any material on the dura were included in the study. Postoperative MRI images of the patients with and without collagen membranes were examined and evaluated whether the material used was effective in preventing arachnoiditis and / or epidural fibrosis and granulation tissue formation. Results: Nine female patients (37.5%) and 15 male patients (62.5%) of 24 patients were in the collagen membrane-free group. Four of the patients in the collagen membrane group were female (25%) and 12 were male (75%). The mean age of the non-membrane group was 35.47 ± 9.06, and the mean age of the membrane group was 37.40 ± 8.92 years. According to MRI findings, granulation tissue and epidural fibrosis were not observed in 8 (50%) of 16 patients with collagen membranes, whereas granulation tissue was observed in 8 (50%) patients. Granulation tissue was not observed in 10 (41.7%) of 24 patients without collagen membrane, whereas epidural fibrosis and granulation tissue formation was observed in 14 (58.3%). Based on these results, there was no statistically significant relationship between type-I collagen membrane use and granulation tissue formation. (P = 0.604 <0.05). There was no difference between the rate of granulation tissue (50%) and absence (50%) in patients with type-I collagen membranes. Conclusion: According to these results and MRI findings, it was found that peroperative type-I collagen membrane use in lumbar discectomy did not have a statistically significant effect on granulation tissue or epidural fibrosis formation.

Keywords:

lumbar disk herniation, epidural fibrosis, collagen membrane, MRI,

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