Spontan regresyon gösteren disk herniasyonları

Yıl 2023, Cilt: 7 Sayı: 1, 53 - 58, 21.06.2023

Veli Çıtışlı

https://doi.org/10.30565/medalanya.1217069

Öz

Amaç: Vertebral disk hernileri sık görülen bir klinik durumdur. Cerrahiye gitmeden iyileşen vakalar vardır. Spontan regresyon gösteren disk hernilerini istatistiksel olarak anlamlı şekilde ortaya koyan bir toplu çalışma yapılmamıştır. Amacımız, cerrahi endikasyona rağmen, spontan regresyon gösteren disk hernisi vakalarını belirleyip istatistiksel olarak anlamlı şekilde ortaya koymaktır.

Yöntemler: Bu amaçla, 4,5 yıldır beyin cerrahisine gelen 2700 hastanın dosyalarından retrospektif kohort yapıldı. 341 hastaya cerrahi endikasyon kondu. 323 hasta opere edildi. Cerrahi endikasyona rağmen ameliyat olmayan 18 hastaya fizik tedavi, ilaç tedavisi, istirahat önerildi. 18 hastanın kontrol MRG sonuçlarına göre disk hernilerinin spontan gerilediği belirlendi. İnsidans, rölatif risk (RR), atfedilen risk (AR) ve korunabilirlik hızı hesaplandı. Demografik değerler için SPSS’de ortalamaların karşılaştırılması kullanıldı. Ki-kare testi yapıldı. P<0,05 istatistiki olarak anlamlı kabul edildi.

Bulgular: Disk herrnisi spontan regresyon gösterenlerin yaş ortalaması 46,4 idi. Yaş olarak iki grupta istatistiki olarak anlamlı bir fark yoktu (P>0,05). En fazla spontan regresyon Lumbal 5 Sakral 1’de görüldü. 4,5 yıl için vertebral disk hernisi insidansı % 12.62 bulundu. Rölatif risk, 1.06 bulundu. Cerrahi uygulananlarda, pozitif etken olarak cerrahi girişimin % 94 hastada tam iyileşme olduğu belirlendi. Negatif etken olarak, cerrahi endikasyon olduğu halde cerrahi yapılmayan, istirahat, medikal ve fizik tedavi uygulananlarda tam iyileşme %100’dü. Cerrahi endikasyonu olup, cerrahi yapılanlar %94,42, cerrahisiz spontan regresyona gidenler %5,57 bulundu. Cerrahi gitmeyenlerin tüm hastalar içindeki yüzdesi % 0,66 idi. Disk hernilerinde, cerrahisiz spontan regresyon düşünülmesi istatistiki olarak anlamlı bulundu (p<0,05).

Sonuç: Uygun klinik takipteki disk hernilerinde cerrahi tedaviden önce spontan regresyon ihtimalinin göz önünde bulundurulmalı, vücudun iyileşme yönünde inflamatuar yanıtına zaman verilmelidir

Anahtar Kelimeler

Disk herniasyonu, spontan regresyon, kohort, retrospektif

Destekleyen Kurum

Yok.

Proje Numarası

Yok

Teşekkür

Yok

Disc herniations with spontaneous regression

Öz

Aim: Vertebral disc hernias are a common clinical condition. There are reported cases of recovery without surgery. However, no collective study has yet been conducted to reveal spontaneously regressing disc hernias statistically significant. Our aim is to determine the cases of spontaneous regression disc herniation and to reveal statistically significant and to reveal the chance of spontaneous regression without surgery.

Methods: For this purpose, a retrospective cohort was made from the files of 2,700 patients who came to our clinic during a period of 4.5 years. Surgical indication was determined in 341 patients and 323 patients were operated on. Physical and drug therapy as well as rest were recommended to 18 patients. These 18 patients who did not receive surgical treatment, it was determined that the disc hernias had spontaneous regression. Incidence, relative risk (RR), attributable risk (AR), and rate of protection were calculated. Comparison of the means in the SPSS and Chi-square test.

Results: The most spontaneously regressed disc herniation was determined as L5S1 level. In those treated surgically, surgical intervention as a positive factor was found to provide complete recovery in 94% of patients. Surgery indication determined that 94.42% of those who had surgery were indicated and those who did not undergo surgery and went to spontaneous regression, represented 5.57%. Spontaneous regression of disc hernias without surgery was found to be statistically significant (p<0.05).

Conclusion: It is important to consider the possibility of spontaneous regression before surgical treatment in disc herniations. In disc herniation, time should be allocated for the body's inflammatory response to heal.

Anahtar Kelimeler

Disc herniation, spontaneous regression, cohort, retrospective

Proje Numarası

Yok

Kaynakça

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