Yerine Bir Şey Konulmaksızın Yapılan Diskektomi Ameliyatı Ağrı ve Limitli Ağız Açıklığı Olan Hastalarda İlk Tercih Olmalı mıdır?

Amaç: Bu çalışmada; diskektomi operasyonu öncesi ve sonrası iç düzensizlikleriolan hastaların, ağrı ve fonksiyonel gelişimi değerlendirildi. Gereç ve Yöntemler: Bu retrospektif kohort çalışmada internal düzensizliği olanhastalara yerine bir şey konulmaksızın diskektomi uygulanan hastaların ağrı vefonksiyonel gelişimi değerlendirildi. Birincil ana değişkenler ameliyat öncesi vesonrası maksimum ağız açıklığı (MAA), Görsel Analog skalasına (VAS) göre ağrı idi. Ortalamaları, farklılıkları, ameliyat öncesi ve sonrası ağız açıklığı ile ameliyat öncesi ve sonrası VAS’si belirlemek için eşleştirilmişörnekelem t-testi kullanıldı. Bulgular: Altısı bilateral ve 14’ü unilateral olmak üzere yerine bir şey konulmaksızın diskektomi uygulanan toplam 20 hasta çalışmayadahil edildi. Eşleştirilmiş örneklem t-testi sonuçları; ameliyat öncesi ve sonrası MAA’da bir fark olduğunu, VAS ölçeğinde ise ağrıaçısından fark olmadığını göstermiştir. Wilkes sınıflandırmasına göre hastaların ameliyat öncesi ve sonrası MAA değerleri arasındakifark hastaların dosya verilerinden kaydedilmiştir. Bu bulgulara dayanarak, evre III ve IV’teki hastaların ameliyat öncesi ve sonrasıortalama MAA’ları arasında fark gözlenmezken, evre V ve III’teki hastalar arasında anlamlı bir fark görülürken (p0,05). Sonuç: Wilkes III ve IV hastalarında yerine bir şey konulmaksızın diskektomi, konservatif tedavinin başarısız olduğu durumlarda ağrıyıhafifletmek ve fonksiyonları iyileştirmek için iyi bir tedavi seçeneğidir

Should Discectomy Performed WithoutReplacement be the First Choice inPatients with Pain and Reduced MouthOpening?

Objective: In this study, we evaluated the pain and functional development of patients with internal derangements before and after discectomy.Materials and Methods: This was a retrospective cohort study in which patients with internal derangement underwent discectomy without replacement. The main primary variables were pre- and post-operative maximum mouth opening (MMO) and pain according to the Visual Analogue scale (VAS). Paired t-test was used to compare means to determine the differences between pre- and post-operative mouth opening and pre- and post-operative VAS.Results: Among the 20 patients included in this study, six and 14 underwent bilateral and unilateral discectomy without replacement, respectively. Paired sample t-test results revealed that there was a difference in MMO pre- and postoperatively, whereas the VAS scale showed no difference in terms of pain. According to the Wilkes classification, the difference between pre- and post-operative MMO of the patients was recorded. Based on these findings, no difference was observed between the mean pre- and post-operative MMOs of Wilkes stage III and IV patients, whereas a significant difference was found between Wilkes stage V and III patients (p0.05).Conclusion: In Wilkes stage III and IV subjects, discectomy without replacement is a good treatment option to relieve pain and improve functions in cases where conservative treatment fails

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