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Alt servikal omurganın travmatik kırık ve dislokasyonları: tek merkez bulguları
2018
Journal:  
Cukurova Medical Journal
Author:  
Abstract:

Amaç: Alt servikal omurganın (C3-7) yaralanmaları; aksiyal iskeletinsık görülen ve potansiyel olarakkatastrofik yaralanmaları arasında sayılmaktadır. Gençlerde daha çok motorlu taşıt kazalarıyla, yaşlılarda ise düşmelerle ortaya çıkmaktadır. Bu çalışmanın amacı kliniğimizde alt servikal omurga yaralanmaları nedeniyle cerrahi olarak tedavi edilen olgularla ilgili deneyimlerimizi paylaşmaktır. Gereç ve Yöntem: 2014-2016 tarihleri arasında alt servikal omurganın travmatik kırık ve dislokasyonları nedeniyle kliniğimizde opere edilen 27 olguya ait demografik, klinik ve radyolojik veriler ile cerrahi teknikler ve tedavi sonuçları incelenmiştir. Hastalar Spinal Travma Çalışma Grubu tarafından tanımlanan “Subaxial Injury Classification and Severity Scale” (SLICS) ile sınıflandırılmıştır.  Bulgular: Hastaların yaş ortalaması 44.8±17.4 yıldı (21 erkek, 6 kadın). Travmalar; hastaların 2/3’ünde motorlu taşıt kazası, üçte birinde ise düşme sonucu oluşmuştu. %70.4 hastada pre-operatif nörolojik defisit mevcuttu (%40.7'sinde kuadriparezi/kuadripleji). Hastaların tamamında, SLIC skorları 4 veya üzerinde bulundu (ortalama 6.9±2.0). 12 hastaya hem anterior hem posterior, 11 hastaya yalnızca anterior, 4 hastaya ise yalnızca posterior stabilizasyon yapıldı. Post-op dönemde hastaların %18.5'inde pnömoni gelişirken, 3 hasta (%11) komplikasyonlar nedeniyle kaybedildi. Sonuç: Servikal omurga yaralanmaları, önemli mortalite ve morbidite nedenleri arasındadır. İnstabilitenin önlenmesi ve omurilik üzerindeki baskının kaldırılmasına yönelik olarak erken dönemde uygulanan dekompresyon ve stabilizasyonun sonuçları yüz güldürücüdür. Ayrıntılı pre-operatif klinik ve radyolojik değerlendirme, ameliyat kararının verilmesinde ve doğru yaklaşımın seçilmesinde yol göstericidir.

Keywords:

Traumatic fractures and dislocations of the lower cervical spine: single center findings
2018
Author:  
Abstract:

Purpose: The injury of the lower cervical spine (C3-7) is one of the actional and potentially catastrophic injury. The number of motorcycle accidents is increased in young people, while the number of motorcycle accidents is increased in older people. The aim of this study is to share our experiences with the phenomena that are theraped by surgery due to lower cervical spinal injuries in our clinic. Tools and Methods: Demographic, clinical and radiological data of 27 cases operated in our clinic due to traumatic fractures and dislocations of the lower cervical spine between 2014-2016 and the surgical techniques and treatment results have been studied. Patients are classified by the Subaksial Injury Classification and Severity Scale (SLICS) defined by the Spinal Trauma Working Group. The average age of patients was 44.8±17.4 years (21 men, 6 women). Three-thirds of patients were caused by motorcycle accidents and one-thirds were caused by crashes. 70.4 percent of patients had pre-operative neurological deficit (40.7 percent were quadriparesis/quadripley). In all patients, the SLIC scores were found 4 or higher (an average of 6.9±2.0). 12 patients were both anterior and posterior, 11 patients were only anterior and 4 patients were only posterior stabilization. In the post-op period, 18.5% of patients developed pneumonia, while 3 patients (11%) lost due to complications. The result: cervical spinal injuries are among the major causes of mortality and morbidity. The results of decompression and stabilization in the early period aimed at preventing instability and eliminating pressure on the spine are ridiculous. Detailed pre-operative clinical and radiological assessment is a guide in the decision of surgery and the choice of the right approach.

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Cukurova Medical Journal

Field :   Sağlık Bilimleri

Journal Type :   Uluslararası

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Cukurova Medical Journal