Adil Turan, Fehmi Doruk Kuran, Ferhat Güler, Ebru Sezer, Yigit Uyanıkgil, Osman Arslan Bora

Medulla Spinalis Yaralanmasının Kırık İyileşmesi Üzerindeki Etkisi (Sıçanlarda Deneysel Çalışma)

Spinal travma sonrası oluşan sinir iletim kaybı zemininde gelişen kırıklarda iyileşme ve kemik metabolizması normalden farklılıklar göstermektedir. Sinir iletiminin kesintiye uğramasının kemik metabolizması ve kırık iyileşmesini ne yönde etkilediğini araştırmak ve konu ile ilgili mekanizmalar geliştirmek amacı ile bu deneysel çalışma planlandı. Kırk beş adet Wistar albino cinsi sıçan randomize olarak 3 gruba ayrıldı. Grup 1’de (n=20) lomber seviyeden spinal travma sonrası sağ tibiada kapalı kırık oluşturuldu. Grup 2’de (n=20) spinal travma olmadan kırık meydana getirildi. Grup 3’te (n=5) ise hiçbir müdahale yapılmamış sıçanlar kullanıldı. Çalışmanın 35. gününde sıçanlar sakrifiye edilerek kan örnekleri alındı ve kırık ekstremiteleri çıkartıldı. Materyeller histopatolojik ve biokimyasal olarak incelendi. Grup 1’de ameliyat sonrası anlamlı derecede kilo kaybı tespit edildi ve kemik yapımını gösteren kan ve kallus BALP düzeyleri yüksek saptandı. Kallus kalsiyum düzeylerinde ise anlamlı şekilde azalma tespit edildi. Kemik yıkım belirteci olarak kullanılan hidroksiprolin düzeylerinde gruplar arasında anlamlı bir fark bulunamadı. Yapılan histopatolojik çalışmada ise, kallus boyutunun travma grubunda diğer gruba oranla anlamlı derecede fazla olduğu görülürken, matürasyon derecesinin ise kontrol grubuna göre geride olduğu tespit edildi. Spinal travma nedeniyle oluşan sinir iletimindeki kesintinin, kırık iyileşmesinin mineralizasyon fazını olumsuz yönde etkilemesine karşın kallus boyutunda artışa neden olmaktadır

Anahtar Kelimeler:

Kırık iyileşmesi, spinal travma, BALP

Effects of Medulla Spinalis Injury on Fracture Healing

In fractures developing on the basis of the nerve conduction loss occurring after spinal trauma, healing and bone metabolism demonstrate departure from normal. The objective of this study is to study the type of effect which the interruption in the nerve conduction has on bone metabolism and bone healing and to develop relevant mechanisms. 45 Wistar Albino rats were randomized and divided into 3 groups. In Group 1 (n=20), a close fracture was created at the right tibia following spinal trauma at the lumbar level. In Group 2 (n=20), a fracture was created without spinal trauma. Finally, Group 3 (n=5) was made up of rats with no intervention. On the 35th day of the study, rats were sacrificed; blood samples were taken and fractured extremities were removed. Materials were histopathologically and biochemically examined. Significant weight loss was detected postoperatively in Group 1. In the same group, blood and callus BALP levels indicating bone formation were observed to be high. A significant decrease was also identified in callus calcium levels. Employed as a determinant of bone resorption, hydroxyproline levels did not demonstrate any significant differences. On the other hand, upon histopathological examination, callus size was observed to be significantly larger in the trauma group than in the other group, while the degree of maturation was lower than that of the control group. Interruption of nerve conduction induced by spinal trauma is observed to give way to an increase in callus size, despite its negative effect on the mineralization phase of bone healing.

Keywords:

Fracture healing, spinal injury, BALP,

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