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Üst Seviye Lomber Disk Hernileri

High Level Lomber Disc Hernias

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Aim: The scope of this study is to investigate the correlation between the clinical and radiological findings of high level lomber disc hernia (L1-2, L2-3, L3-4) and surgical outcome. Material and Method: 23 high level lomber disc hernia out of 262 lomber disc cases operated between January1996 and November 2001 at the department of Neurosurgery , Faculty of Medicine, İnönü Üniversity (Malatya Turkey) were retrospectively reviewed. Results: 39.1% of the cases were male and 60.9% were female. The mean age was 49.6. The mean interval between the initial complaint and the admittance was 3.7 months. The incidence of high level lumbar disc hernia wa s 8.8% and were mostly seen on L3-L4 level (78.3%). CT and myelography were performed in 13% of the cases and MRI and CT on the rest (87%). Only one case having the initial operation in our clinic required a second surgery with the diagnosis of recurrent disc hernia. Conclusion: None of the patients after surgery declared preoperative pain. Postoperative early evaluation using Prolo scale revealeed 56% good and 44% fair results. Reevaluation on the postoperative sixth month disclosed 87% good and 13% fair results. All of the patients benefited from surgery.
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Abstract (Original Language): 
Amaç: Üst seviye lomber disk hernilerinin (Ll-2, L2-3, L3-4) klinik ve radyolojik incelemesi ile cerrahi sonuçlarının değerlendirilmesi Yöntem: Ocak 1996- Kasım 2001 tarihleri arasında İnönü Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı'nda opere edilen 262 lomber disk hernisi arasından 23 üst seviye lomber disk hernisi retrospektif olarak incelendi. Bulgular: Olguların %39.1'i erkek, %60.9'u kadındı. Yaş ortalaması ise 49.6'idi. Şikayetin başlangıcı ile başvuru arasında geçen süre ortalama 3.7 aydı. Üst seviye lomber disk hernilerinin görülme sıklığı %8.8 olduğu ve L3-4 seviyesinde yoğunlaştığı (%78.3) saptandı. Olguların %13'üne BT ve Myelografi, %87' sine BT ve Lomber MRI yapıldı. İlk operasyonu kliniğimizce yapılan olgulardan 1'i (%4.8) nüks disk hernisi nedeniyle 2. kez opere edildi. Sonuç: Postoperatif erken dönemde bütün olguların ağrı yakınmaları kayboldu. Yine postoperatif erken dönemde Prolo takip skalası iyi olan olgular %56, orta %44 iken, 6. ayda yapılan kontrol muayenelerinde Prolo takip skalasına göre iyi sonuç oranı %87, orta %13 olarak bulundu. Prolo takip skalasına göre kötü olgumuz yok.
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  • 4
249-254
  • Turkish

REFERENCES

References: 

1. Nadler SF, Campagnolo DI, Tomaio AC, Stitik TP. High lumbar disc: Diagnostic and treatment dilemma. Am J Physical Medicine & Rehabilitation 1998; 77; 6: 538- 544.
253
Üst Seviye Lomber Disk Hernileri
2. Bosacco SJ, Berman AT, Raisis LW, Zamarin RI. High lumbar disc herniation.
Orthopedics 1989; 12: 275- 278.
3. Hsu K, Zucherman J, Shea W, et al. High lumbar disc degeneration: incidence and
etiology. Spine 1990; 15: 679- 682.
4. Prolo DJ, Oklund SA, Butcher M. Toward uniformity in evaluating results of lumbar spine operations. Spine 1986; 11; 6: 601- 606.
5. Gutterman P, Shenkin HA. Syndromes associated with protrusion of upper lumbar intervertebral discs. J Neurosurg 1982; 57: 813- 816.
6.
Demirba
ş MA. Üst seviye lomber disk hernilerinde insidans, klinik özellikler, tanı ve tedavi yöntemlerinin değerlendirilmesi. 2000; Uzmanlık tezi: Haydarpaşa Numune Eğitim ve Araştırma Hastanesi.
7. Vloeberghs M, Noterman J, Levivier M, Baleriaux D, Brotchi J. A patient with two upper lumbar disc herniations. Acta Orthop Belg 1992; 58(3): 339- 342.
8. Albert TJ, Balderston RA, Heller JG, Herkowitz HN, Garfin SR, Tomany K, An
HS, Simeone FA. Upper lumbar disc herniations. J Spinal Disord 1993; 6(4): 351¬359.
9. Rastecchini F. Results of surgery compared with conservative management for
lumbar disc herniations. Spine 1991; 21(11): 1383- 1387.
10. Eugene J, Kim DH. A prospective analysis of magnetic rezonance imaging findings in patients with sciatica and LDH. Spine 1997; 22(15): 1650- 1660.
11. Yasuma T, Arai K, Yamauchi Y. The histology of lumbar intervertebral disc
herniations. Spine 1993; 18(13): 1761- 1765.
12. Kotilainen E, Valtonen S, Carison CA. Microsurgical treatment of lumbar disc
herniation: Follow up of 237 patients. Acta Neurochir (Wien) 1993; 120: 143¬149.
13. Junge A, Drovak J. Predictors of bad and good outcomes of lumbar disc surgery
Spine 1995; 20 (4): 460- 468.
14. Estridge MN, Rouke SA, Johnston NG. The femoral stretching test. J Neurosurgery 1982; 57: 813- 816.
15. Paszlar E, Szervas I. Herniation of the upper lumbar discs. Neurosurg Rev 1981;
4(3): 151- 157.
16. Kostuik JP, Harington J, Alexander D, Rond W. Cauda equina syndrome and lumbar disc herniation. The Journal of bone and joint surgery 1986; 68A (3): 386¬390.
17. Shapiro S. Cauda equina syndrome secondary to lumbar disc herniation.
Neurosurgery 1993; 32 (5): 743- 746.
18. Jacson RP, Cain JE, Jacops RR, McManus GE. The neuroradiographic diagnosis of lumbar herniated nucleus pulposus: Comparison of computed tomography, myelography, CT- myelography, discography and CT- discography. Spine 1989; 14 (12): 1362- 1367.
19. Herzog RJ. The radiologic assesement for a lumbar disc herniation. Spine 1996;
21(245): 19- 38
20. Williams RW. Microdiscectomy-myth, mania or mile stone? An 18 years surgical adventure. Adv Neurosurgery 1977; 4: 81- 87.
21. Caspar W, Campbell B, Barbier DD, Kretschmmer R, Gotfried Y. The Caspar microsurgical discectomy and comparison with a conventional standart lumbar disc prosedure. Neurosurgery 1991; 28 (1): 78- 86.
22. Conrad T, Pappas E, Harrington T, Sonntag H. Outcome analysis in 654 surgically treated lumbar disc herniations. Neurosurgery 1992; 30(6): 862- 866.
23. Yaşargil MG. Microsurgical operation of the herniated lumbar disc. Adv
Neurosurgery 1977; 4: 81- 87.
24. Rogers LA. Experience with limited versus extensive disc removal in patients undergoing microsurgical operations for ruptured lumbar disc. Neurosurgery
1988; 22(1): 82- 85.
25. Carlson G, Abitbol JJ, Garfin SR. Prevention of complications in surgical management of back pain and sciatica. Orthopedics Clinics of North America
1991; 22(2): 345- 351.
26. Sayegh FE, Kapetanoz GA, SymeonidosPP, Anogiannakis G. Functional outcome after experimental cauda equina compression. The Journal of Bone and
Joint Surgery 1996; 79B(4): 670- 673.

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