Metehan ESEOĞLU, İlhan YILMAZ, Ahmet EROĞLU

Lomber disk hernisi olan genç hastalarda faset eklem açı özelliklerinin lomber disk hernisi gelişimindeki rolünün araştırılması

Amaç: Çalışmamızda lomber disk hernisi (LDH) olan genç hastalarda faset tropizmini ve faset tropizminin LDH gelişimindeki rolünü araştırmak amaçlanmıştır. Gereç ve yöntem:LDH’si olan 20- 32 yaş arasındaki 57 hasta ile lomber disk hernisi olmayan sağlam olarak kabul ettiğimiz 46 hastanın lomber Manyetik Rezonans Görüntüleme (MRG) tetkiklerinde L3-4, L4-5, L5-S1 mesafesinde bilateral faset eklem açıları aksiyal planda ölçüldü. Karşılıklı her iki faset eklem açısı arasında fark 14° ise ağır tropizm olarak sınıflandırıldı. Bulgular:LDH’li 57 hastada 342, kontrol grubu 46 hastada 276 olmak üzere toplam 618 faset açısı ölçüldü. LDH grubununda L3-4 seviyesinde, %80.7’sinde (n=46) tropizm olmadığı, %15,7’sinde (n=9) orta derecede tropizm olduğu, %2’sinde (n=3.5) ağır derecede tropizm olduğu görüldü. L4-5 seviyesinde, % 63.1’inde (n=36) tropizm olmadığı, %29.8’inde (n=17) orta derecede tropizm olduğu, %7sinde (n=4) ağır derecede tropizm olduğu görüldü. L5-S1 seviyesinde %57.9’unda (n=33) tropizm olmadığı, %29.8’inde (n=17) orta derece tropizm olduğu, %12.2’sinde (n=7) ağır tropizm olduğu tespit edildi. Kontrol grubunda ise L3-4 seviyesinde, %87’sinde (n=40) tropizm olmadığı, %10.9’unda (n=5) orta derecede tropizm olduğu, %2.2’sinde (n=1) ağır tropizm olduğu tespit edildi. L4-5 seviyesinde, %80.4’ünde (n=37) tropizm olmadığı, %17.3’ünde (n=8) orta derecede tropizm olduğu, %2.1’inde (n=1) ağır tropizm olduğu görüldü. L5-S1 seviyesinde %73.9’unda (n=34) tropizm olmadığı, %15.2’sinde (n=7) orta derece tropizm olduğu, %10.9’unda (n=5) ağır tropizm olduğu tespit edildi. LDH’li grupta faset açı ortalamaları L3-4’te 40.4; L4-5’t; 42.7; L5-S1’de 45.9 idi. Kontrol grubu faset açı ortalamaları L3-4’te 39.2; L4-5’te 41.4; L5-S1’de 43.9 derece idi. Sonuç: Çalışmamızda faset eklem tropizmi, LDH’li hastalarda kontrol grubuna göre bir miktar yüksek oranda görülüyor olmasına rağmen istatistiksel olarak anlamı olmadığını belirledik (p>0.05). LDH etiyolojisinde faset tropizminin predispozan bir faktör olarak rol oynamadığını düşünmekteyiz.

An Evaluation of the facet joint angle characteristics on the development of lumbar disc hernia in young patients

Purpose:The aim of the current study was to investigate facet tropism in young patients with lumbar disc hernia(LDH) and the role of facet tropism in the development of LDHMaterials and methods:The study included 57 patients aged 20-32 years with a diagnosis of LDH and bilateralfacet joint angles at L3-4, L4-5 and L5-S1 levels measured on lumbar magnetic resonance imaging (MRI)tests. In the comparison of the two facet joint angles, a difference of 14° as severe tropism. A control group was formed of 46 age-matched healthyindividuals with no lumbar disc hernia.Results:A total of 618 facet facet angles were measured, comprising 342 in the 57 patients in the LDH groupand 276 in the 46 subjects of the control group. In the LDH group, at the L3-4 level, no tropism was determinedin 46 (80.7%), moderate tropism in 9 (15.7%) and severe tropism in 2 (3.5%). At the L4-5 level, no tropism wasdetermined in 36 (63.1%), moderate tropism in 17 (29.8%) and severe tropism in 4 (7%). At the L5-S1 level,no tropism was determined in 33 (57.9%), moderate tropism in 17 (29.8%) and severe tropism in 7 (12.2%).Inthe control group, at the L3-4 level, no tropism was determined in 40 (87%), moderate tropism in 5 (10.9%) andsevere tropism in 1 (2.2%). At the L4-5 level, no tropism was determined in 37 (80.4%), moderate tropism in 8(17.3%) and severe tropism in 1 (2.1%). At the L5-S1 level, no tropism was determined in 34 (73.9%), moderatetropism in 7 (15.2%) and severe tropism in 5 (10.9%).In the LDH group, the mean facet angle values were 40.4° at L3-4, 42.7° at L4-5 and 45.9° at L5-S1 levels. In thecontrol group, the mean facet angle values were 39.2° at L3-4, 41.4° at L4-5 and 43.9° at L5-S1 levels.Conclusion: Although facet joint tropism was seen at a higher rate in the LDH patients than in the control group,the difference was not statistically significant (p>0.05). The results of the study did not suggest that facet tropismis a factor in the etiology of LDH.

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