Turkish Journal of Physical Medicine and Rehabilitation 1999 , Vol 2 , Num 4

Lomber Disk Hernili Olgularda, Cerrahi Tedavinin Dejeneratif Süreç Gelişimi Üzerine Olası Etkileri

Teoman Aydın 1 ,Hakan Seyithanoğlu 2 ,Mahmut Remzi Savaş 3 ,Şafak Şahir Karamehmetoğlu 4 ,Halil Koyuncu 5 ,İlhan Karacan 6
1 SSK Vakıf Gureba Eğgitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul
2 Vakıf Gureba Eğiüim ve Araştırma Hastanesi, Nörşirurji Kliniği, İstanbul
3 Vakıf Gureba Eğitim ve Araştırma Hastanesi Radyoloji Bölümü, İstanbul
4 İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye
5 İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul
6 Serbest Fiziyatrist

Possible Effects of Surgical Treatment on Development of Degeneration Stage in Cases with Lumbar Disc Herniation. One of the treatment methods applied in lumbar disc herniation (LDH) is surgical attempt. The purpose of this study is to learn whether surgical attemt will cause to development of degeneration stage in intervertebral joint. Twenty-eight LDH cases that surgical treatment was applied in the first year that LDH was diagnosed and 28 LDH cases that conservative treatment was applied were included in this study. There was no statistically significant difference between age and disease duration of the groups. The mean duration after surgical attempt 3.6 (2.4 years. The applied surgical attempt was laminectomy and/or discectomy. Lumbar 2-way graphs and computed tomography of all cases were taken and evaluated blindly. Radiological spondylosis findings (osteophyte, narrowing in joint space, sclerosis, vacuum fenomenon) at level applied surgiccal attemps were compared with radiological spondylosis findings at same level in cases with LDH. After all lumbar vertebral segments (L1-L5) were evaluated, it was seen that risk of development joint degeneration was too much 4.5-20 times in cases applied surgical attempts than cases with LDH. It can be said that surgical attempt increases the development risk of spondylosis and the increasing risk may be related to deteriorated biomechanics.

Keywords : lumbar disc herniation, surgical treatment, degeneratio