Lomber Disk Hernisinde Disk Restorasyon Hidrojel İmplant (Gelstixtm) Kullandığımız Hastalarda Sonuçlar: Retrospektif Kohort Çalışması

Ayşe AZAK BOZAN, Sibel Özcan, Mikail Kilinç, Meryem IŞIK SEÇ, Selami Ateş Önal
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Abstract

Introduction: The aim of this study is evaluting the results of disc restoration hidrogel implanted (GelstixTM) lomber disc hernia patients. Material-Method: Patients suffered from chronic back pain diagnosed lumber disc hernia who were admitted to Firat University Algology Clinic and treated with disc restoration hidrogel between January 2013 – January 2014 were evaluated. Cases were evaluated for demografic characteristics, magnetic resistance imaging findings, preoperative and postoperative VAS, complications, side effects and patients satisfaction after prosedure. Results: Of the operated 62 patients were 25 male (40,3%) and 37 female (59,7%). Mean age of all patients was 49,18±14,18 years, mean age of female patients was 50,81±13,37 years and mean age of male patients was 46,76±15,27 years. Mean duration of pain in female and male patients was 37,81±37,92 months and 25,36±33,58 months, respectively. Preoperative and postoperatif VAS scores of female and male patients were 8,24±1,09 and 7,88±1,01 and 3,56±2,11 and 3,76±2,17, respectively. Of the 62 patients suffered from 16 right leg pain (25,8%), 20 left leg pain (32,3%), 26 bilateral lower limb pain (41,9%). Of 62 patients 31 had no additional disorders (50%), 12 had cardiac disorders (19,4%), 3 had (4,8%) respiratory disorders, 7 had endocrine disorders (11,3%), 4 had both endocrine and cardiac disorders (6,5%), 2 had both cardiac and respiratory disorders (3,2%), 1 had both endocrine and respiratory disorders (1,6%), and 2 had both endocrine, cardiac and respiratory disorders (3,2%). Of the 62 patients 25 had bulging (40,3%), 5 had protrusion (8,1%), 4 had narrowed neural foramen (6,5%), 18 had bulging +narrowed neural foramen (29%), 3 had narrowed neural foramen + protrusion (4,8%) and 7 had bulging + protrusion (11,3%). Thirteen patients hadn’t had previous therapy (20,97%), transforaminal steroid injection was applied to 29 patients (46,77%) and medical threapy (such as NSAID, miyorelactants) was applied to 20 (32,26%). Levels of complaints were 2 at L2-L3 (3,2%), 17 at L3-L4 (27,4%), 28 at L4-L5 (45,2%) and 15 at L5-S1 (24,2%). Without L2-L3 level other operated levels had significant difference between preropeative VAS scores and postoperative VAS scores. The number of unsatissfied patients was 9 (14,5%), moderated satisfied patients number 16(25,8%),good satisfied patients number was 16 (25,8%), and perfectly satisfied patients number was 21 (33,9%). Conclusion: Disc restoration hidrogel is a safe minimal invasive technique with satisfactory results, low complication rates and low side effect risk especially in young and middle aged patients.
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在Lomber椎间盘突出症中,我们使用椎间盘复位氢植入物(Gelstixtm)结果:回顾性队列研究
简介:本研究的目的是评估椎间盘修复植入凝胶(GelstixTM)的腰椎间盘突出患者的结果。材料-方法:对2013年1月- 2014年1月在Firat University Algology Clinic接受椎间盘修复hidrogel治疗的诊断为腰椎间盘突出的慢性背痛患者进行评估。评估病例的人口学特征、磁共振成像结果、术前和术后VAS、并发症、副作用和术后患者满意度。结果:62例手术患者中,男性25例(40.3%),女性37例(59.7%)。患者平均年龄分别为49、18±14、18岁,女性患者平均年龄分别为50、81±13、37岁,男性患者平均年龄分别为46、76±15、27岁。女性和男性患者的平均疼痛时间分别为37、81±37、92个月和25、36±33、58个月。男女患者术前、术后VAS评分分别为8分、24±1分、09分和7分、88分±1分、01分和3分、56分±2分、11分和3分、76分±2分、17分。62例患者中右腿疼痛16例(25.8%),左腿疼痛20例(32.3%),双侧下肢疼痛26例(41.9%)。62例患者中,31例无其他疾病(50%),12例有心脏疾病(19.4%),3例有呼吸疾病(4.8%),7例有内分泌疾病(11.3%),4例同时有内分泌和心脏疾病(6.5%),2例同时有心脏和呼吸疾病(3.2%),1例同时有内分泌和呼吸疾病(1.6%),2例同时有内分泌、心脏和呼吸疾病(3.2%)。62例患者中,膨出25例(40.3%),突出5例(8.1%),神经孔狭窄4例(6.5%),膨出+神经孔狭窄18例(29%),神经孔狭窄+突出3例(4.8%),膨出+突出7例(11.3%)。既往未接受治疗的患者13例(20.97%),经椎间孔类固醇注射患者29例(46.77%),药物治疗(如非甾体抗炎药、心肌相关药物)患者20例(32.26%)。L2-L3有2例(3.2%),L3-L4有17例(27.4%),L4-L5有28例(45.2%),L5-S1有15例(24.2%)。除L2-L3水平外,其他手术水平术前VAS评分与术后VAS评分差异有统计学意义。不满意者9例(14.5%),中等满意者16例(25.8%),较满意者16例(25.8%),完全满意者21例(33.9%)。结论:椎间盘修复术是一种安全的微创技术,效果满意,并发症发生率低,副作用低,尤其适用于中青年患者。
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