Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi
Yıl: 2018 Cilt: 29 Sayı: 1 Sayfa Aralığı: 4 - 7 Metin Dili: Türkçe İndeks Tarihi: 05-04-2019
Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi
Öz: Amaç: Perkütan vertebroplasti (PVP) spinal cerrahide sık uygulanan girişimyöntemlerinden biridir. Bu girişime bağlı en yaygın komplikasyon kemikçimento migrasyonudur. Çimento migrasyonu çoğu zaman asemptomatik olsada parapleji, pulmoner embolizm gibi ciddi komplikasyonlara yol açabilir.Yaptığımız bu çalışmada vertebroplasti girişimlerinde meydana gelen kemikçimento kaçağını saptamak ve PVP işleminin sonuçlarını değerlendirmek vemeydana gelen komplikasyonların sonuçlarını değerlendirerek gelecekdönemde yapılacak girişimlere ışık tutmasını amaçladık.Yöntem: Kliniğimizde 2009-2016 yılları arasında perkütan vertebroplastiuygulanan 20 (14 K ve 6 E) hasta ve girişimde bulunulan 26 vertebra çalışmayadahil edildi. Onyedi vertebra osteoporotik kompresyon (%65.3), 4 vertebrapatolojik kompresyon fraktürü (%15.3), 4 vertebra travmatik kompresyonfraktürü (%15.3), 1 vertebra ise hemanjiom (%3.8) nedeniyle işleme alındı.Kemik çimentonun migrasyon lokalizasyonları venöz pleksus, paravertebralyumuşak doku, spinal kanal, intervertebral foramen, kanül trasesinin içi ve diskmesafesi olarak sınıflandırıldı.Bulgular: Vertebraların 12’sinde korpus dışına kaçak izlenmezken (%46.1), 5vertebrada kanül trasesine kaçak (%19.2), 3 vertebrada disk mesafesine kaçak(%11.5), 2’şer vertebrada venöz pleksus ve paravertebral dokulara kaçak(%7.6), 1’er vertebrada ise foraminal ve spinal kanal kaçak (%3.8) izlendi.Meydana gelen komplikasyonlara bağlı 1 hastada radiküler ağrı meydanageldi. Hastaların % 80 inde tam ağrı kontrolü sağlanırken ,%20 sinde kısmi ağrıkontrolü izlendi.Tartışma : Perkütan vertebroplasti girişiminde majör komplikasyonlarınmeydana gelmesini engellemek için olası kaçak nedenlerinin belirlenmesi,uygulamanın doğru teknik ile yapılması, uygun miktar ve kıvamda kemikçimento kullanılması gerekmektedir. Çimento uygulaması öncesinde kaçakolasılığını belirlemek amacı ile kontrast kullanılarak x- ray kontrollerininyapılması olası kötü sonuçları en aza indirgemek için dikkat edilemesi gerekenhususların başında yeralmaktadır.
Anahtar Kelime: Konular:
Bone Cement Leakage in Transpedicular Percutaneous Vertebroplasty: Analysis of 20 Patients
Öz: Objective: Percutaneous vertebroplasty (PVP) is one of the frequently preferred interventional methods in spinal surgery. Although it is classified as minimally invasive, the most common complication of this procedure is bone cement leakage. Leakage of bone cement is often asymptomatic, but can lead to serious complications such as paraplegia and pulmonary embolism.In this study, we aimed to investigate the complications and consequences of cement leakage in the percutaneous vertebroplasty procedure. Methods: Between 2009 and 2015, 20 (14 female and 6 male, mean age 69.7) patients who underwent percutaneous vertebroplasty to 26 vertebrae were included in the study. 17 vertebrae were treated for osteoporotic compression (65.3%), 4 vertebrae for pathologic compression fractures (15.3%), 4 vertebrae for traumatic compression fractures (15.3%) and 1 vertebrae for painful hemangioma (3.8%). Leakage localizations of bone cement were classified as venous plexus, paravertebral soft tissue, spinal canal, intervertebral foramen, into the niddle channel and intervertebral disc space. Results: Twelve vertebrae showed no leakage (46.1%). 5 vertebrae had leakage into the niddle channel (19.2%), and 3 had leakage to vertebra disc space leakage (11.5%) and 2 vertebrae had to venous plexus and paravertebral tissue leakage (7.6%) Foraminal and spinal canal leakage (3.8%) was observed in one patient on single level. Radicular pain was seen in one patient. Partial pain control was observed in 20% of the patients while 80% of the patients had complete pain control on follow ups. Conclusion: Major complications following percutaneous vertebroplasty are mostly due to bone cement leaks. In order to prevent major complications, it is necessary to determine the possible causes of leakage. Performing the application with the correct technique with properly prepared bone cement is essential. Also usage of contast dye may be useful for pre-injection risk of leakage complications.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | ÇİVİ S, Durdağ E, SUNER H, KARDEŞ Ö, Tufan K (2018). Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. , 4 - 7. |
| Chicago | ÇİVİ Soner,Durdağ Emre,SUNER Halil Ibrahim,KARDEŞ ÖZGÜR,Tufan Kadir Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. (2018): 4 - 7. |
| MLA | ÇİVİ Soner,Durdağ Emre,SUNER Halil Ibrahim,KARDEŞ ÖZGÜR,Tufan Kadir Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. , 2018, ss.4 - 7. |
| AMA | ÇİVİ S,Durdağ E,SUNER H,KARDEŞ Ö,Tufan K Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. . 2018; 4 - 7. |
| Vancouver | ÇİVİ S,Durdağ E,SUNER H,KARDEŞ Ö,Tufan K Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. . 2018; 4 - 7. |
| IEEE | ÇİVİ S,Durdağ E,SUNER H,KARDEŞ Ö,Tufan K "Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi." , ss.4 - 7, 2018. |
| ISNAD | ÇİVİ, Soner vd. "Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi". (2018), 4-7. |
| APA | ÇİVİ S, Durdağ E, SUNER H, KARDEŞ Ö, Tufan K (2018). Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. Gazi Medical Journal, 29(1), 4 - 7. |
| Chicago | ÇİVİ Soner,Durdağ Emre,SUNER Halil Ibrahim,KARDEŞ ÖZGÜR,Tufan Kadir Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. Gazi Medical Journal 29, no.1 (2018): 4 - 7. |
| MLA | ÇİVİ Soner,Durdağ Emre,SUNER Halil Ibrahim,KARDEŞ ÖZGÜR,Tufan Kadir Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. Gazi Medical Journal, vol.29, no.1, 2018, ss.4 - 7. |
| AMA | ÇİVİ S,Durdağ E,SUNER H,KARDEŞ Ö,Tufan K Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. Gazi Medical Journal. 2018; 29(1): 4 - 7. |
| Vancouver | ÇİVİ S,Durdağ E,SUNER H,KARDEŞ Ö,Tufan K Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi. Gazi Medical Journal. 2018; 29(1): 4 - 7. |
| IEEE | ÇİVİ S,Durdağ E,SUNER H,KARDEŞ Ö,Tufan K "Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi." Gazi Medical Journal, 29, ss.4 - 7, 2018. |
| ISNAD | ÇİVİ, Soner vd. "Perkütan Transpediküler Vertebroplastide Kemik Çimento Kaçağı: Yirmi Hastanın Analizi". Gazi Medical Journal 29/1 (2018), 4-7. |
