Öz
Objective: To emphasize the advantages of a left-sided
approach compared to opening the cervical region from the right side in
patients with cervical disc hernia undergoing surgery for any reason.
Method: A total of 10 patients with a history of
surgery in the right cervical region were operated on with a left-side approach
because of disc hernia at a single cervical level between 2013 and 2018. The
patients comprised 6 males and 4 females. Of the whole patient group, 5 had
previously undergone surgery for cervical disc hernia, 3 for goitre, 1 with
hydrocephalus because the shunt traversed the medial of the distal end of the
sternocleidomastoid muscle, and 1 patient who had not been operated on but had
goitre of giant dimensions extending to the right.
Results: All the patients were diagnosed with
cervical disc hernia from MRI findings and neurological examination. The
operation of single level cervical disc surgery was performed with an approach
from the left in all 10 patients avoiding opening from a recurrence area. No
complications developed and the complaints were seen to recover.
Conclusions: In the light of previous reports in
literature, it can be emphasized that to prevent complications in cervical disc
surgery, rather than an approach from a previously operated region, it could be
more advantageous to open from the opposite side.
Anahtar Kelimeler
Kaynakça
- 1. Yaycıoğlu S, Gökpınar D. Anterior girişimle ameliyat edilen servikal disk hernilerinin değerlendirilmesi (servikal disk ameliyatı).Adnan Menderes Üniversitesi Tıp Fakültesi Dergisi. 2003, 4(2),11-14.
- 2. Orakdöğen M, Döşoğlu M, Ateş Ö, Demirbaş MA, Özdoğan C, Tevrüz M. The results of anterior approach in cervical disc hemiation. Acta Orthop Traumatol Turc. 1997; 3: 327-330.
- 3. Ebraheim NA, Lu J, Skie M, Heck BE, Yeasting RA. Vulnerability of the recurrent laryngeal nerve in the anterior approach to the lower cervical spine. Spine 1997; 22: 2664–7.
- 4. Netterville JL, Koriwchak MJ, Courey MS, Winkle M, Ossoff RH. Vocal fold paralysis following the anterior approach to the cervical spine. Ann Otol Rhinol Laryngol. 1996; 105: 85–91.
- 5. Kasimcan Ö, Kaptan H, Çakiroğlu K, Kiliç C. Servikal Disk Hernisinde Peek Cage'in Erken Dönem Sonuçları. Archives of Neuropsychiatry/Noropsikiatri Arsivi. 2009, 46(3).
- 6. Özay R , Çetinalp NE , Kalan M , Oğur T. Dislocation and Spontan Resorbtion of the Bone Graft after Anterior Cervical Discectomy Operation: Case Report. Türk Nöroşirürji Dergisi. 2012, Cilt: 22, Sayı: 3, 232-234.
- 7. O’Shea J, Sundaresan N, Steinberger AA, Moore F. Surgical approaches to the cervicothoracic junction. In: Menezes AH, Sonntag VKH, eds. Principles of Spinal Surgery. New York: McGraw-Hill. 1996, 1253–61.
- 8. Geiger M, Roth PA, Wu JK. The anterior cervical approach to the cervicothoracic junction. Neurosurgery. 1995, 37: 704–9.
- 9. Nemiroff PM, Katz AD. Extralaryngeal divisions of the recurrent laryngeal nerve: surgical and clinical significance. 1982, Am J Surg ; 144: 466–9.
- 10. Skandalakis JE, Droulias C, Harlaftis N, Tzinas S, Gray SW, Akin JT. The recurrent laryngeal nerve. Am Surg. 1976, 42: 629–34.
- 11. Haller J M, Iwanik M, Shen F. H. Clinically relevant anatomy of recurrent laryngeal nerve. Spine.2012, 37(2), 97-100.
- 12. Jeon, JK, Oh CH, Chung D, Lee J, Choi SH, Choi E, Ji GY. Prevertebral vascular and esophageal consideration during percutaneous cervical disc procedures. Spine. 2014, 39(4), 275-279.
- 13. Fard SA, Patel AS, Avila MJ, Sattarov KV, Walter CM, Skoch J, Baaj AA. Anatomic considerations of the anterior upper cervical spine during decompression and instrumentation: a cadaveric based study. Journal of Clinical Neuroscience. 2015, 22(11), 1810-1815.
- 14. Beutler WJ, Sweeney CA, Connolly PJ. Recurrent laryngeal nerve injury with anterior cervical spine surgery: risk with laterality of surgical approach. Spine. 2001, 26(12), 1337-1342.
- 15. Apfelbaum RI, Kriskovich MD, Haller JR. On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine. 2000, 25 (22), 2906-2912.
Öz
Amaç: Bu çalışmada sağ taraflı açılışla servikal
bölgeden herhangi bir nedenle opere olmuş servikal disk hernili hastaların
soldan yaklaşımın avantajları vurgulanmıştır.
Yöntem: 2013-2018 yılları arasında özgeçmişinde
sağ servikal bölgeden opere olmuş 10 hastanın servikal tek seviye disk hernisi
nedeniyle soldan yaklaşım ile operasyonu yapıldı. Hastaların 6 sı erkek 4 ü
kadındı. Tüm hasta grubunun 5 tanesi servikal disk hernisi nedeniyle opere
olmuştu, 3 hasta guatr nedeniyle opere, 1 hasta hidrosefali nedeniyle opere
olmuş şant distal ucu sternokleidomastoid kası medialeinden geçiyordu, 1 hasta
ise opere olmamış dev boyutta sağa uzanan guatrı mevcuttu.
Bulgular: Tüm hasta grubu MRI bulguları ve nörolojik
muaynesi ile servikal disk hernisi tanısı aldı. Nüks bölge açılışından
kaçınılarak 10 hastada tek seviye servikal disk cerrahisini soldan yaklaşımla
opere edildi. Komplikasyon olmadı, şikayetlerin geçtiği görüldü.
Sonuç: Servikal disk cerrahisinde
komplikasyonları önleme açısından reoperasyon bölgesinden yaklaşımdansa karşı
taraftan açılışın daha avantajlı olacağını literatür eşliğinde vurgulamaktayız.
Anahtar Kelimeler
Kaynakça
- 1. Yaycıoğlu S, Gökpınar D. Anterior girişimle ameliyat edilen servikal disk hernilerinin değerlendirilmesi (servikal disk ameliyatı).Adnan Menderes Üniversitesi Tıp Fakültesi Dergisi. 2003, 4(2),11-14.
- 2. Orakdöğen M, Döşoğlu M, Ateş Ö, Demirbaş MA, Özdoğan C, Tevrüz M. The results of anterior approach in cervical disc hemiation. Acta Orthop Traumatol Turc. 1997; 3: 327-330.
- 3. Ebraheim NA, Lu J, Skie M, Heck BE, Yeasting RA. Vulnerability of the recurrent laryngeal nerve in the anterior approach to the lower cervical spine. Spine 1997; 22: 2664–7.
- 4. Netterville JL, Koriwchak MJ, Courey MS, Winkle M, Ossoff RH. Vocal fold paralysis following the anterior approach to the cervical spine. Ann Otol Rhinol Laryngol. 1996; 105: 85–91.
- 5. Kasimcan Ö, Kaptan H, Çakiroğlu K, Kiliç C. Servikal Disk Hernisinde Peek Cage'in Erken Dönem Sonuçları. Archives of Neuropsychiatry/Noropsikiatri Arsivi. 2009, 46(3).
- 6. Özay R , Çetinalp NE , Kalan M , Oğur T. Dislocation and Spontan Resorbtion of the Bone Graft after Anterior Cervical Discectomy Operation: Case Report. Türk Nöroşirürji Dergisi. 2012, Cilt: 22, Sayı: 3, 232-234.
- 7. O’Shea J, Sundaresan N, Steinberger AA, Moore F. Surgical approaches to the cervicothoracic junction. In: Menezes AH, Sonntag VKH, eds. Principles of Spinal Surgery. New York: McGraw-Hill. 1996, 1253–61.
- 8. Geiger M, Roth PA, Wu JK. The anterior cervical approach to the cervicothoracic junction. Neurosurgery. 1995, 37: 704–9.
- 9. Nemiroff PM, Katz AD. Extralaryngeal divisions of the recurrent laryngeal nerve: surgical and clinical significance. 1982, Am J Surg ; 144: 466–9.
- 10. Skandalakis JE, Droulias C, Harlaftis N, Tzinas S, Gray SW, Akin JT. The recurrent laryngeal nerve. Am Surg. 1976, 42: 629–34.
- 11. Haller J M, Iwanik M, Shen F. H. Clinically relevant anatomy of recurrent laryngeal nerve. Spine.2012, 37(2), 97-100.
- 12. Jeon, JK, Oh CH, Chung D, Lee J, Choi SH, Choi E, Ji GY. Prevertebral vascular and esophageal consideration during percutaneous cervical disc procedures. Spine. 2014, 39(4), 275-279.
- 13. Fard SA, Patel AS, Avila MJ, Sattarov KV, Walter CM, Skoch J, Baaj AA. Anatomic considerations of the anterior upper cervical spine during decompression and instrumentation: a cadaveric based study. Journal of Clinical Neuroscience. 2015, 22(11), 1810-1815.
- 14. Beutler WJ, Sweeney CA, Connolly PJ. Recurrent laryngeal nerve injury with anterior cervical spine surgery: risk with laterality of surgical approach. Spine. 2001, 26(12), 1337-1342.
- 15. Apfelbaum RI, Kriskovich MD, Haller JR. On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine. 2000, 25 (22), 2906-2912.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Mart 2019 |
| Kabul Tarihi | 20 Mart 2019 |
| Yayımlandığı Sayı | Yıl 2019 |