Bülent Bakar, Mustafa Öğden, Ulaş Yüksel, Mehmet Faik Özveren, İbrahim Akkurt, Ahmet Turan Dağlı

Posterior Spinal Yaklaşımla Transpedikuler Vida Fiksasyonu Yapılan Hastalarda “Halo İşareti” Gelişimindeki Potansiyel Risk Faktorleri

Omurgaya doğru şekilde yerleştirilmeyen transpediküler vidaların kemik yapı içerisinde hareketine ikincil olarak vidaların etrafında ortaya çıkabilen fibröz dokuya radyolojik terminolojide "halo işareti" adı verilmektedir. Bu retrospektif klinik çalışmada, torasik, lomber veya torakolomber vertebra için posterior spinal enstrümantasyon yapılan 141 hasta incelendi ve bu hastalardaki spinal enstrümantasyonun muhtemel başarısızlığını ortaya koyan "halo işareti" oluşumu bilgisayarlı tomografi (BT) ve direkt grafi görüntüleri kullanılarak değerlendirildi. Bu klinik çalışmada 2014-2018 yıllarına ait hastane kayıtları incelenerek "omurga kırığı", "spondiloz", "spondilolistez" ve “intervertebral disk hernisi” gibi nedenlerle posterior yaklaşımla lomber, torakal ve torakolomber spinal enstrümantasyon uygulanan yetişkin hastalar çalışmaya dahil edildi. Hastaların omurgaları, ameliyat sonrası takip döneminde elde edilen direkt grafi görüntüleri ve BT görüntüleri kullanılarak değerlendirildi. Bulgular: 13 hastada halo belirtisi görüldü. Halo işareti olan ve halo işareti olmayan hastalar arasında yaş (p = 0.013), vida kullanılan omurga sayısı (p = 0.001) ve transpediküler vida sayısı (p

Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach

It has been shown in literature that a fibrous tissue called "halo sign" in the radiological terminology can develop aroundthe transpedicular screws implanted incompletely and/or incorrectly, which appears after movement of the screw in the cancellousbone. In this retrospective clinical study, 141 patients who underwent posterior spinal instrumentation for thoracic, lumbar orthoracolumbar vertebrae were evaluated using computed tomography (CT) and direct X-rays images for "halo sign" formationwhich refers in probable failure of spinal instrumentation. Hospital records included in the year 2014-2018 were examined and adultpatients who were performed lumbar, thoracal, and thoracolumbar spinal instrumentation via posterior approach due to reasons suchas "spine fracture", "spondylosis", "spondylolisthesis" and "intervertebral disc hernia" were included and evaluated in this study.The age and sex of the patients were recorded. Spinal X-ray and spinal CT images obtained during the postoperative follow-upperiod were examined. Halo sign was seen in 13 patients. Age (p=0.013), number of instrumented vertebrae (p=0.001) and numberof transpedicular screws (p

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