Ulus Travma Acil Cerrahi Derg. 2019; 25(5): 484-488 | DOI: 10.5505/tjtes.2018.86721

Travmatik torakolomber bileþke yaralanmalý hastalarda steroidin nörolojik sonuçlar üzerine etkisi

Kemal Ilik¹, Fatih Keskin², Mehmet Fatih Erdi², Bülent Kaya², Yaþar Karataþ², Erdal Kalkan^2
1Farabi Hastanesi, Nöroþirürji Kliniði, Konya
²Necmettin Erbakan Üniversitesi Meram Týp Fakültesi, Nöroþirürji Anabilim Dalý, Konya

AMAÇ: Bu çalýþmada metilprednizolonun torakolomber bileþke (T10-L1) kýrýklarý ile beraber spinal kord yaralanmasý olan hastalarda nörolojik sonuçlarýna etkisi deðerlendirildi.
GEREÇ VE YÖNTEM: Eylül 2008–Ocak 2015 aylarý arasýnda torakolomber bileþke kýrýðý nedeniyle ameliyat ettiðimiz 182 hastanýn bilgileri geriye dönük olarak deðerlendirildi. Hastalar iki gruba ayrýldý. Grup 1; erken cerrahi ile beraber metilprednizolon tedavisi uygulanan grup iken, Grup 2; metilprednizolon tedavisi verilmeyen sadece erken cerrahi uygulanan gruptu. Hastalarýn ilk baþvuruda ve son muayene kayýtlarýna göre motor indeks skorlarý Amerikan Spinal Yaralanma Birliði (ASIA) skalasýna göre deðerlendirildi. Sonuçlar istatistiki olarak karþýlaþtýrýldý.
BULGULAR: Grup 1’de ortalama takip süresi 14.4±1.4 iken Grup 2’de 13.6±1.7 idi. Hastalarýn baþlangýçta ve son muayene kayýtlarýnda ASIA skorlarý benzerdi (p>0.05). Komplikasyon oraný ise Grup 1’de belirgin þekilde yüksekti (p<0.05).
TARTIÞMA: Bulgularýmýza göre spinal kord yaralanmasý olan hastalarda steroidin nörolojik sonuçlar üzerine belirgin faydalý etkisi yoktur ve yan etkisiyle komplikasyon oranýný arttýrmaktadýr.

Anahtar Kelimeler: Metilprednizolon, spinal kord yaralanmasý; tedavi; torakolomber bileþke.

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The effects of steroids in traumatic thoracolumbar junction patients on neurological outcome

Kemal Ilik¹, Fatih Keskin², Mehmet Fatih Erdi², Bülent Kaya², Yaþar Karataþ², Erdal Kalkan^2
1Department of Neurosurgery, Farabi Hospital, Konya-Turkey
²Department of Neurosurgery, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey

BACKGROUND: In this study, we aim to evaluate the potential effects of methylprednisolone on the neurological outcome of spinal cord injury (SCI) patients with thoracolumbar junction (T10-L1) spine fractures.
METHODS: The data from 182 SCI patients who sustained a thoracolumbar junction spine fracture were operated by us between September 2008 to January 2015 were analysed retrospectively. The patients were divided into two groups: Group 1 underwent methylprednisolone treatment in conjunction with early surgical intervention, while group 2 underwent only early surgical intervention without methylprednisolone treatment. American Spinal Injury Association (ASIA) motor index scores of the patients were evaluated and compared with statistical methods at admission and at the first-year follow-up.
RESULTS: The main follow-up period was 14.4±1.4 months in group 1 and 13.6±1.7 months in group 2. Initial and last follow-up ASIA scores of the patients were similar between groups (p>0.05), but the complication rate was significantly high in group 1 (p<0.05).
CONCLUSION: The findings showed that steroids have no significant beneficial effects on the neurological outcome but have significant side effects and leads to increased complication rate in SCI patients.

Keywords: Methylprednisolone, spinal cord injury; thoracolumbar junction; treatment.

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