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

BAKAR, BULENT; ÖĞDEN, MUSTAFA; Ozveren, Mehmet Faik; yüksel, ulaş; Dağlı, Ahmet Turan; Akkurt, Ibrahim

doi:10.20515/otd. 551271

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

Mustafa Öğden, (Kırıkkale Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Kırıkkale Türkiye)

Ulaş Yüksel, (Yıldırım Beyazıt Üniversitesi, Yenimahalle Eğitim ve Araştırma Hastanesi, Nöroşirurji Kliniği, Ankara, Türkiye)

İbrahim Akkurt, (Yozgat Şehir Hastanesi, Nöroşirurji Kliniği, Yozgat, Türkiye)

Ahmet Turan Dağlı, (Hitit Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Çorum, Türkiye)

Bülent Bakar, (Kırıkkale Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Kırıkkale Türkiye)

Mehmet Faik Özveren (Kırıkkale Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Kırıkkale Türkiye)

Osmangazi Tıp Dergisi

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Yıl: 2020 Cilt: 42 Sayı: 2 Sayfa Aralığı: 212 - 221 Metin Dili: İngilizce DOI: 10.20515/otd. 551271 İndeks Tarihi: 01-04-2021

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

Öz:

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<0.001) values were different between the patients with halo sign and patients without halo sign. As aresult, it was observed in this study that the formation of the halo sign in posterior spinal instrumentation system could develop inproportion to the number of transpedicular screw and patients' age. It was thought that the halo sign formation was not connectedwith the parameters called performed laminectomy, gender, inserted intervertebral cage, or vertebral region which were insertedtranspedicular screws.

Anahtar Kelime:

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

Öz:

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 <0.001) değerleri farklıydı. Bu çalışmanın sonucunda, posterior spinal enstrümantasyon sisteminde halo işaretinin oluşumunun transpediküler vida sayısı ve hasta yaşı ile orantılı olarak gelişebileceği gözlendi. Halo işareti oluşumunda “laminektomi” uygulanmasının, “intervertebral kafes” uygulanmasının, cinsiyetin veya “transpediküler vidanın uygulandığı omurga seviyesi”nin etkili olmadığı düşünüldü.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÖĞDEN M, yüksel u, Akkurt I, Dağlı A, BAKAR B, Ozveren M (2020). Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. , 212 - 221. 10.20515/otd. 551271
Chicago	ÖĞDEN MUSTAFA,yüksel ulaş,Akkurt Ibrahim,Dağlı Ahmet Turan,BAKAR BULENT,Ozveren Mehmet Faik Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. (2020): 212 - 221. 10.20515/otd. 551271
MLA	ÖĞDEN MUSTAFA,yüksel ulaş,Akkurt Ibrahim,Dağlı Ahmet Turan,BAKAR BULENT,Ozveren Mehmet Faik Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. , 2020, ss.212 - 221. 10.20515/otd. 551271
AMA	ÖĞDEN M,yüksel u,Akkurt I,Dağlı A,BAKAR B,Ozveren M Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. . 2020; 212 - 221. 10.20515/otd. 551271
Vancouver	ÖĞDEN M,yüksel u,Akkurt I,Dağlı A,BAKAR B,Ozveren M Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. . 2020; 212 - 221. 10.20515/otd. 551271
IEEE	ÖĞDEN M,yüksel u,Akkurt I,Dağlı A,BAKAR B,Ozveren M "Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach." , ss.212 - 221, 2020. 10.20515/otd. 551271
ISNAD	ÖĞDEN, MUSTAFA vd. "Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach". (2020), 212-221. https://doi.org/10.20515/otd. 551271

APA	ÖĞDEN M, yüksel u, Akkurt I, Dağlı A, BAKAR B, Ozveren M (2020). Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. Osmangazi Tıp Dergisi, 42(2), 212 - 221. 10.20515/otd. 551271
Chicago	ÖĞDEN MUSTAFA,yüksel ulaş,Akkurt Ibrahim,Dağlı Ahmet Turan,BAKAR BULENT,Ozveren Mehmet Faik Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. Osmangazi Tıp Dergisi 42, no.2 (2020): 212 - 221. 10.20515/otd. 551271
MLA	ÖĞDEN MUSTAFA,yüksel ulaş,Akkurt Ibrahim,Dağlı Ahmet Turan,BAKAR BULENT,Ozveren Mehmet Faik Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. Osmangazi Tıp Dergisi, vol.42, no.2, 2020, ss.212 - 221. 10.20515/otd. 551271
AMA	ÖĞDEN M,yüksel u,Akkurt I,Dağlı A,BAKAR B,Ozveren M Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. Osmangazi Tıp Dergisi. 2020; 42(2): 212 - 221. 10.20515/otd. 551271
Vancouver	ÖĞDEN M,yüksel u,Akkurt I,Dağlı A,BAKAR B,Ozveren M Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach. Osmangazi Tıp Dergisi. 2020; 42(2): 212 - 221. 10.20515/otd. 551271
IEEE	ÖĞDEN M,yüksel u,Akkurt I,Dağlı A,BAKAR B,Ozveren M "Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach." Osmangazi Tıp Dergisi, 42, ss.212 - 221, 2020. 10.20515/otd. 551271
ISNAD	ÖĞDEN, MUSTAFA vd. "Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach". Osmangazi Tıp Dergisi 42/2 (2020), 212-221. https://doi.org/10.20515/otd. 551271