Organ nakli sonrası spinal enstrumantasyon sonuçları: Retrospektif kohort çalışma

Amaç: Organ nakli cerrahisi, anestezi ve postoperatif bakım daki gelişmeler transplant hastalarında ek cerrahi girişimlerin de yapılabilmesinin önünü açmıştır. Bu çalışmanın amacı farklı organ nakilli hastalarda omurga cerrahisinin sonuçlarını incelemektir. Yöntemler: Farklı etiyolojilerle omurga cerrahisi uygulanan 10 transplant hastası çalışmaya dahil edildi. Yedi hasta (%70) böbrek nakli, 2 hasta (%20) karaciğer ve 1 hasta (%10) akciğer nakli olmuştu. Hastaların 6’sı (%60) spinal stenoz, 3’ü (%30) vertebra kırığı ve 1’i (%10) vertebra metastazı sebebi ile omurga cerrahisi geçirmişti. Hastaların ameliyat öncesi ve sonrası radyolojik, klinik ve fonksiyonel durumları ve ağrı skorlamaları incelendi. Ameliyat süreleri, kan transfüzyon ihtiyacı ve hastanede kalış zamanları not edildi. Bulgular: Hastaların yaş aralığı 38-62 yıl ve yaş ortalaması 57,1 (8,9) idi. Hastaların altısı erkek, dördü kadındı. Transplant cerrahisinden omurga ameliyatına kadar geçen süre ortalama 15,6 (2,1) ay bulundu. Hastalara ameliyat esnasında ortalama 5,6 (0,8) ünite eritrosit süspansiyonu verildi. Hastanede kalış süresi ortalama 8,5 (5,6) gündü. İki hastada ameliyat sonrası minör komplikasyon gelişti. Hastaların ameliyat öncesi 6,4 (0,8) olan VAS ağrı skorlarının 3,1’e (1,6) düştüğü gözlendi (P<0.001).Sonuç: Posterior spinal enstrumantasyon, transplant hastalarında da yaşam kalitesini arttırmada etkili bir yöntemdir. Tecrübeli bir ekip ve multidispliner yaklaşım şarttır.

Anahtar Kelimeler:

Organ nakli, Hepatosellüler karsinom, Omurga cerrahisi, Omurga metastazı, Enstrumantasyon

Evaluation of spinal instrumentation following organ transplantation: A retrospective cohort study

Aim: Improvements in transplantation medicine and surgery, anesthesiology, and postoperative care paved the way for successful procedures for transplant patients. The aim of the present study is to describe the results of surgical correction for spinal deformities in patients who underwent several types of organ transplantation. Methods: The study group consisted of ten patients with a history of organ transplantation who require spinal surgery with different etiologies. Seven (70%), two (20%) and one (10%) patient had lung, liver, and lung transplantations, respectively. The etiology for spinal surgery was spinal stenosis in six (60%), vertebra fracture in three (30%), and vertebral metastasis in one (10%) patient. Pre- intra- and postoperative radiological, clinical, and functional outcomes were noted. Results: The mean age of the patients was 57.1 (8.9) years, ranging between 38-62 years. Six of the patients were male, and four were female. Surgery time following the transplant surgery was 15.6 (2.1) months. The blood requirement in the operating room was 5.6 (0.8) units of erythrocyte suspension. Hospital length of stay was 8.5 (5.6) days following the spinal instrumentation surgery. Two patients had mild complications in the postoperative period. The preoperative VAS score significantly decreased from 6.4 (0.8) to 3.1 (1.6) after the surgery (P<0.001).Conclusions: Posterior spinal instrumentation on transplanted patients can be an effective treatment which improves the life quality of the patients. A multidisciplinary approach with an experienced team is highly required.

Keywords:

Organ transplantation, Hepatocellular carcinoma, Spinal surgery, Spine metastasis, Instrumentation,

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