Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Mikrodiskektomi Cerrahisi Olan ve Olmayan Lomber Disk Hernili Bireylerde Erken Dönemde Ağrı, Yaşam Kalitesi ve Fonksiyonelliğin Karşılaştırılması: Randomize Olmayan Prospektif Kontrollü Çalışma
Comparison of Pain, Quality of Life and Functionality in Early Period of Lomber Disc Hernia with and Without Microdiscectomy Surgery: A Non-Randomized Prospective Controlled Trial
Ecehan CANSUa, Hayri Baran YOSMAOĞLUb
aBaşkent Üniversitesi Ankara Hastanesi, Fizyoterapi ve Rehabilitasyon Bölümü, Ankara, TÜRKİYE
bBaşkent Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2022;7(1):167-74
doi: 10.5336/healthsci.2020-73334
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, lomber disk hernisi olan bireylerde mikrodiskektomi cerrahisinin 4 haftalık erken dönemde ağrı, yaşam kalitesi ve fonksiyonelliğe etkisini, cerrahi yapılmayan hastalarla karşılaştırarak ortaya koymaktır. Gereç ve Yöntemler: Çalışmanın vaka grubuna, lomber disk hernisi tanısı alan ve mikrodiskektomi yöntemiyle ameliyat edilen 28 hasta dâhil edildi. Çalışmanın kontrol grubuna ise lomber disk hernisi tanısı alan ancak cerrahi yapılmayan, sadece eklem koruma prensipleri hakkında bilgi verilen 25 hasta dâhil edildi. Yaşam kalitesi Kısa Form-36 (KF-36) Yaşam Kalitesi Ölçeği ile, fonksiyonel durum Oswestry Özürlülük İndeksi ile (OÖİ) ve ağrı, McGill-Melzack Ağrı Ölçeği ile çalışma başlangıcında ve dört hafta sonunda değerlendirildi. Bulgular: Cerrahi yapılan grupta; KF-36 Yaşam Kalitesi Ölçeği (fiziksel fonksiyon farkı p=0,001; fiziksel rol farkı p=0,001; emosyonel rol farkı p=0,04; sosyal işlevsellik farkı p=0,001; ağrı farkı p=0,001), OÖİ (p=0,001) ve McGill-Melzack Ağrı Ölçeği (p=0,001) skorlarında istatistiksel olarak iyileşme olduğu bulundu (p<0,05). Cerrahi olmayan disk hernili grupta ise ağrı, fonksiyonellik ve yaşam kalitesi parametrelerinde istatistiksel bir değişiklik saptanmadı. Sonuç: Son yıllarda literatürde, üzerinde yoğun tartışmaların yapıldığı mikrodiskektomi cerrahisi uygulamasının, lomber disk hernisi tanılı bireylerde ağrıyı kısa dönemde azalttığı, fonksiyonellik ve yaşam kalitesinde artış meydana getirdiği saptandı. Klinik sonuçların, cerrahi yapılmayan hastalara göre daha iyi olması, cerrahi tedavinin akut dönemde etkili bir tedavi seçeneği olduğunu göstermektedir. Benzer çalışmaların uzun izlem periyotlarını içerecek şekilde yapılması, bu cerrahinin kalıcı sonuçları hakkında daha fazla bilgi verecektir.

Anahtar Kelimeler: Diskektomi; bel ağrısı; yaşam kalitesi
ABSTRACT
 Objective: The aim of this study was to examine the early effects of microdiscectomy surgery on pain, functional disability and quality of life in patients with lumbar disc herniation. Material and Methods: The case group of the study included 28 patients diagnosed with lumbar disc hernia and operated by microdiscectomy method. In the control group of the study, 25 patients who were diagnosed with lumbar disc herniation but were not operated, and only information about the principles of joint protection were included. Quality of life was evaluated with the Short Form-36 (SF-36) Quality of Life Scale, functional status was evaluated with the Oswestry Disability Index (SDI), and pain was evaluated with the McGill Melzack Pain Scale at the beginning of the study and at the end of four weeks. Results: A statistically significant improvement was found in the SF-36 Quality of Life Scale (physical function difference p=0.001, physical role difference p=0.001, emotional role difference p=0.04, social functionality difference p=0.001, pain difference p=0.001), ODI (p=0.001) and McGill-Melzack Pain Questionnaire scores (p=0.001) in the surgical group (p<0.05). In the non-surgical disc herniation group, there was no statistical change in pain, functionality and quality of life parameters. Conclusion: It has been found that the application of microdiscectomy surgery, on which there has been intense discussion in the literature in recent years, reduced pain in the short term and increased functionality and quality of life in individuals with lumbar disc herniation. The better clinical results compared to non-surgical patients shows that it is an effective treatment option in the acute period. Conducting similar studies including long follow-up periods will provide more information about the permanent results of this surgery.

Keywords: Discectomy; low back pain; quality of life
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