Mustafa ÖĞDEN, SÜLEYMAN AKKAYA, ULAŞ YÜKSEL, Ahmet Turan DAGLI, BÜLENT BAKAR, Mehmet Faik ÖZVEREN

SERVİKAL MİYELOPATİLİ HASTALARDA UNİLATERAL YAKLAŞIM İLE BİLATERAL DEKOMPRESYONUN KLİNİK SONUÇLARI

Amaç: Servikal omurgadaki kemik ve ligamentöz yapıların dejeneratif değişiklikleri spinal kanal darlığına ve spinal kord basısına yol açmaktadır. Posterior destek sağlayan kas, ligament gibi yapıların korunarak, unilateral yaklaşım ile bilateral dekompresyon (UYBD) giderek yaygın olarak uygulanmaktadır. Bu çalışmada, unilateral yaklaşım ile bilateral dekompresyon cerrahi tekniği kullanılarak tedavi edilen servikal spondilotik myelopatili (SSM) hastalarda, bu yöntemin etkinliğini değerlendirmeyi amaçladık.Gereç ve Yöntem: SSM tanısıyla unilateral yaklaşım ile bilateral dekompresyon tekniği ile opere edilen hastaların verileri retrospektif olarak incelendi. Hastaların yaş, cinsiyet, operasyon öncesi ve 1 yıl sonrası ağrı şiddetini gösteren vizüel analog skala (VAS) değerleri ile OSWESTRY Disabilite İndeksi (ODİ) değerleri kayıt edildi.Bulgular: Çalışmamıza yaşları 41 ile 77 arasında değişen (ortalama 60.23±9.5 yıl) toplam 13 hasta dahil edildi. Hastaların %76.9’u erkek idi. Tedavi sonrası VAS ve ODİ değerleri karşılaştırıldığında tedavi sonrası değerlerde istatistiksel olarak anlamlı bir iyileşme görüldü (p=0.001). Sonuç: Çalışmamızda SSM’li hastalarda unilateral yaklaşım ile bilateral dekompresyon cerrahisiyle başarılı sonuçlar elde edilmiştir. SSM’li hastalarda henüz az sayıda çalışmada unilateral yaklaşım ile bilateral dekompresyon tekniği ile tedavinin etkinliği değerlendirilmiş olduğu dikkate alındığında, bu çalışmada elde ettiğimiz sonuçlar bundan sonraki çalışmalara ışık tutacaktır.

Anahtar Kelimeler:

Servikal spinal stenoz, servikal spondiloz, servikal disk hernisi, spinal dekompresyon

Clinical Results of Bilateral Decompression with Posterior Unilateral Approach in Patient with Cervical Myelopathy

Objective: Degenerative changes in bone and ligamentous structures in the cervical spine lead to spinal canal stenosis and spinal cord compression. Bilateral decompression with unilateral approach is increasingly being applied with preserving structures such as muscles and ligaments that provide posterior support. The aim of this study was to evaluate the efficacy of this method in patients with cervical sponylotic myelopathy (CSM) who were treated using bilateral decompression with unilateral approach surgical technique.Material and Method: The data of patients who had CSM and were operated using bilateral decompression with unilateral approach technique were retrospectively reviewed. Demographical features such as age, gender were noted. Preoperative and postoperative (first year) pain severity were evaluated using Visual analogue Scale (VAS) and OSWESTRY Disability Index (ODI).Results: A total of 13 patients aged between 41 and 77 years (mean 60.23±9.5 years) were included. 76.9% of the patients were male. When post-treatment VAS and ODI values were compared, there was a statistically significant improvement in post-treatment values (p=0.001). Conclusion: In our study, successful results were obtained with bilateral decompression with unilateral approach in CSM patients. Considering that the efficacy of the treatment with bilateral decompression with unilateral approach technique has been assessed in a small number of CSM patients, the results obtained in this study will encourage further studies.

Keywords:

Cervical spinal stenosis, cervical spondylosis, cervical disc hernia, spinal decompression,

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