TORAKOLOMBER TRAVMALARDA SPÝNAL ENSTRÜMANTASYON

Günümüzün geliþen teknolojisi ile birlikte yüksek enerjili travma sýklýðý ve buna koþut olarak geliþen vertebral kolon yaralanmalarý önemli ölçüde artmýþtýr. Konservatif tedavinin sonuçlarýnýn yeterli oranda tatminkar olmamasý, instabil torakal ve lomber vertebral kýrýklarýn yeterli stabilizasyonu, daha hýzlý rehabilitasyon, daha kolay bakým ve komplikasyonlarýn azaltýlmasý için daha radikal cerrahi yaklaþýmlarýn yapýlmasý gerektiði özellikle son 15 yýlda yoðunlaþmýþtýr. Bu çalýþmada; torakolomber travmalý 14 hasta deðerlendirilmiþtir. Hastalarýn klinik tablosu Frankel, travma biyomekaniði Denis sýnýflamasýna göre deðerlendirilmiþtir. Hastalara cerrahi tedavi olarak Sine transpediküler vida tekniði, 2 hastaya rod-kanca sistemi ile posterior stabilizasyon, 2'sine anterior enstrümentasyon, 2'sine de anterior ve posterior stabilizasyon yöntemleri uygulanmýþtýr. Ayrýca hastalarýn 8'ine total laminektomi, 2'sine korpektomi yapýlmýþtýr. Hastalar postoperatif üçüncü gün torakolomber korse ile mobilize edilmiþtir. Bu çalýþmada torakolomber travmalarda, travma biyomekaniðine göre uygulanan çeþitli stabilizasyon yöntemleri tartýþýlmýþtýr.

SPINAL INSTRUMENTATION IN THORACOLUMBAR TRAUMAS

Injuries of columna vertebralis had increased together with high energy traumas related with advanced technology. Because of unsatisfactory results of conservative therapies and for rapid rehabilitation aggresive surgical procedures have been widely accepted in last fifteen years. In this study, 14 cases with thoracolumbar traumas were reported. The clinical status of the patients have been according to Frankel classification. Biomechanics of trauma was classified according to Denis classification. For posterior stabilization we applied pedicle screw plating in 8 patients, rod-hook system in 2 patients classified. For anterior stabilization we used anterior instrumentation in 2 cases and we also used combined techniques together with anterior-posterior stabilization in 2 patients. In addition, we performed total laminectomy in 8 patients and corpectomy in 2 cases. All the patients have been mobilized with thoracolumbar brace after 3 days postoperatively in this manuscript. We discussed various techniques of stabilization in thoraco-lumbar injuries according to trauma biomechanics.