ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ
Yıl: 2021 Cilt: 21 Sayı: 3 Sayfa Aralığı: 441 - 453 Metin Dili: Türkçe DOI: 10.5505/amj.2021.30783 İndeks Tarihi: 18-02-2022
ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ
Öz: Amaç: Adölesan idiopatik skolyoz’un (AIS) cerrahi tedavisinde standart yaklaşımı posterior enstrümentasyon ve füzyon (PEF) oluşturur. Tedaviye alternatif, füzyonsuz cerrahi yöntem olan vertebra cisim gerdirme (VBT) ise giderek daha sık kullanılmaktadır. Bu çalışmayla, PEF ve VBT yöntemleri ile ameliyat edilmiş AIS hastalarının düzelme miktarları ve yaşam kalitelerinin karşılaştırılması amaçlanmıştır. Materyal ve Metot: Eşleşmiş kohortlar, 2 yıl takipli 40⁰-70⁰ eğriliği olan AIS hastaları incelenerek elde edildi. Lomber eğriliğin cerrahiye dahil edildiği hastalar çalışmadan çıkartıldı. Hastaların demografik verileri, perioperatif ve takip radyografik ölçümleri ve hasta tarafından bildirilen SRS-22 skorları karşılaştırıldı. Bulgular: Çalışmaya, 16 PEF ve 18 VBT hastası (30K, 4E) dahil edildi. Kohortun ortalama yaşı 13,4 (10-17) yıl ve takip süresi 25,7 (24–32) aydı. Grupların preoperatif üst torasik, ana torasik (MT) ve torakolomber (TL) skolyoz açıları benzerdi. PEF grubunda MT eğrilikte cerrahi düzelme oranı daha fazla (%84–%53, p<0,001) iken, 2. yılda toplam düzelme oranları gruplarda benzerdi (%80–%76, p=0,616). 2. yılda PEF ve VBT gruplarında kendi imaj/görüşünde ve ara toplamda anlamlı iyileşme olduğu saptandı (p<0,001–p=0,037 ve p<0,001–p=0,016). PEF grubunda, fonksiyon/ aktivite alt başlığındaki skorlar 6. ayda ve 2. yılda (p=0,027) ve ağrı, ara-toplam skorları 2. yılda, VBT grubuna göre düşüktü (p=0,020, p=0,036). Sonuç: PEF ve VBT cerrahisi takibinde MT ve TL eğriliklerde 2. yılda benzer oranda düzelme görülmektedir. SRS22 skorlarında iki cerrahi ile benzer iyileşme elde edilirken, VBT’de bu iyileşme dinamik olarak seyretmektedir. İki grup arasında fonksiyon/aktivite, ara-toplam ve ağrı skorlarının VBT grubunda erken dönem ve takipte füzyona kıyasla daha iyi olması, daha uzun takipli geniş hasta serilerinde incelenmelidir.
Anahtar Kelime: OUTCOMES OF POSTERIOR SPINAL FUSION AND VERTEBRAL BODY TETHERING IN PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS AND EVALUATION OF QUALITY OF LIFE
Öz: Objectives: Posterior instrumentation and fusion (PEF) is the standard surgical approach and vertebral body tethering (VBT) emerged as an alternative non-fusion technique in the treatment of idiopathic scoliosis. The aim of this study was to compare the correction and health-related life quality of the patients who have undergone PEF and VBT. Materials and Methods: Matched cohorts were obtained among patients whose curves ranged between 40⁰- 70⁰ who had >2 years follow-up. Patients with a lumbar curve included in surgery were excluded. Patients' demographic data, perioperative and follow-up radiographic measurements, and SRS-22 scores were compared. Results: 16 PEF and 18 VBT patients (30F, 4M) were included. The mean age and follow-up were 13.4 (10-17) years and 25.7 (24–32) months. Preoperative upper thoracic, main thoracic (MT), and thoracolumbar (TL) curves were similar among groups. The surgical correction percentage in the MT curve was greater in the PEF group (84%–53%, p<0.001), while the overall correction percentage at two years was similar (80–76%, p=0.616). There was an improvement in self-image and subtotal scores at two years in PEF and VBT groups (p<0.001–p=0.037 and p<0.001–p=0.016). In the PEF group, function scores at six months and two years (p=0.027), pain and sub-total scores at two years (p=0.020, p=0.036) were found to be lower compared to VBT. Conclusion: Following PEF and VBT surgeries, a similar improvement was observed in MT and TL curves. While similar improvement is achieved in SRS22 scores, this improvement is dynamically progressed in VBT. Whether SRS22 scores are better in the VBT group should be examined in larger patient series with longer follow-up.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Yucekul A, Ergene G (2021). ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. , 441 - 453. 10.5505/amj.2021.30783 |
| Chicago | Yucekul Altug,Ergene Gokhan ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. (2021): 441 - 453. 10.5505/amj.2021.30783 |
| MLA | Yucekul Altug,Ergene Gokhan ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. , 2021, ss.441 - 453. 10.5505/amj.2021.30783 |
| AMA | Yucekul A,Ergene G ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. . 2021; 441 - 453. 10.5505/amj.2021.30783 |
| Vancouver | Yucekul A,Ergene G ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. . 2021; 441 - 453. 10.5505/amj.2021.30783 |
| IEEE | Yucekul A,Ergene G "ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ." , ss.441 - 453, 2021. 10.5505/amj.2021.30783 |
| ISNAD | Yucekul, Altug - Ergene, Gokhan. "ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ". (2021), 441-453. https://doi.org/10.5505/amj.2021.30783 |
| APA | Yucekul A, Ergene G (2021). ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. Ankara Medical Journal, 21(3), 441 - 453. 10.5505/amj.2021.30783 |
| Chicago | Yucekul Altug,Ergene Gokhan ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. Ankara Medical Journal 21, no.3 (2021): 441 - 453. 10.5505/amj.2021.30783 |
| MLA | Yucekul Altug,Ergene Gokhan ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. Ankara Medical Journal, vol.21, no.3, 2021, ss.441 - 453. 10.5505/amj.2021.30783 |
| AMA | Yucekul A,Ergene G ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. Ankara Medical Journal. 2021; 21(3): 441 - 453. 10.5505/amj.2021.30783 |
| Vancouver | Yucekul A,Ergene G ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. Ankara Medical Journal. 2021; 21(3): 441 - 453. 10.5505/amj.2021.30783 |
| IEEE | Yucekul A,Ergene G "ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ." Ankara Medical Journal, 21, ss.441 - 453, 2021. 10.5505/amj.2021.30783 |
| ISNAD | Yucekul, Altug - Ergene, Gokhan. "ADÖLESAN İDİYOPATİK SKOLYOZLU HASTALARDA POSTERİOR SPİNAL FÜZYON VE VERTEBRA CİSİM GERDİRME CERRAHİSİNİN SONUÇLARININ VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ". Ankara Medical Journal 21/3 (2021), 441-453. https://doi.org/10.5505/amj.2021.30783 |
