Gergin omurilik sendromlu hastalarda preop ve postop motor uyarılmış potansiyel, elektrofizyolojik iletim çalışmaları,nörolojik muayene ve lumbosakral MRG tetkiklerinin karşılaştırılması

Abstract

Gergin omurilik sendromu (GOS), omuriligin mekanik gerilmesine bagl olarak altekstremitelerde hareket, duyu bozukluklar ve idrar-gayta inkontinans gibi ilerleyicinorolojik belirti ve bulgular ile ortaya ckan; sklkla kas ve iskelet sistemi sekil bo-zukluklarnn eslik ettigi bir klinik tablodur. [1, 8] Dogumsal veya edinsel nedenlerlegelisebilen bu sendromda, embriyolojik donemde norulasyon kusuru sonucu ortayackan, miyelomeningosel, lipomiyelomeningosel, dermal sinus traktusu, ayrk omurilikmalformasyonu (AOM) ya da kuyruk tomurcugunun kanalizasyon kusuru sonucu or-taya ckan terminal miyelosistosel ve gergin lum terminale gibi hastalklar dogumsal(primer) GOS nedenlerini olusturur.Gecirilmis miyelomeningosel, spinal tumor gibi ameliyatlarn ardndan ya da spinaltravma sonras olusabilecek yapsklklar da edinsel (sekonder) gergin omurilik send-romu nedeni olabilir. GOS tans klinik olarak konulur.Goruntuleme yontemleri, so-matosensoryel uyarlms potansiyeller (SEP) ve urodinami tanya yardmc yontem-lerdir.GOS'un belirlenmesinde en onemli radyolojik tan arac lumbosakral manyetikrezonans goruntulemedir (MRG). [4, 5, 7, 29, 53, 64]Bu calsmamzda, kesin GOS tans bulunan, 18 yas uzeri 20 hastada preop ve post-op klinik, lumbosakral MRG, elektrozyolojik iletim ve motor uyarlms potansiyel(MUP) sonuclar karslastrlmstr.Anahtar Kelimeler: Gergin omurilik sendromu, alt ekstremite elektrozyolojik iletim calsmalar, Motor uyarlms Potansiyel, Lumbosakral Manyetik rezonans goruntuleme,norolojik muayene

Project Title: Pre-operational and post-operational motor stimulated potential,electrophysiological conduction studies in patients with tethered cord syndrome, ne-urological examination and comparison of lumbosacral MRI investigations.Abstract: Tethered cord syndrome (TCS) is a clinical picture occurring togetherwith progressive neurological symptoms and ndings such as movement, sensory im-pairments, and incontinence in lower extremities depending on mechanical regressionof the spinal cord, often accompanied with muscle and skeletal system malformations.[1, 8] Diseases such as terminal myelocystocele and sti lumterminale occurring asa result of canalization impairment of the caudal bud or myelomeningocele, lipomye-lomeningosel, dermal sinus tractus, split spinal cord malformation (SCM) occurringas a result of neurulation impairment in embryologic period in this syndrome thatmay be develop by natal or acquired reasons forms the reasons of natal (primary)(TCS). Cohesions that may be formed following an experienced myelomeningocele,the surgeries such as spinal tumor or after spinal trauma may also a reason of acquired(secondary) tethered cord syndrome. TCS is diagnosed by clinicaly. Many methodsare helpful in TCS diagnosis such as radiological studies, somatosensory evoked po-tentials (SEP) and urodynamics study. The most important radiological diagnosistool used for determining the TCS is lumbosacral magnetic resonance imaging (MRI)[4, 5, 7, 29, 53, 64]In this study, the aim is to compare the results of lumbosacral MRI and electrophy-siological Motor evoked potentials (MEP) and conduction study as preoperationaland post-operational clinical imaging in 20 patients over 18 years old diagnosed withdenitive TCS. We aimed at contributing to the literature and our university withthe results to be obtained in the light of abovementioned information in this studydue the fact that there is no study carried out previously about this subject.Keywords: Tethered cord syndrome, electrophysiological conduction studies in lo-wer extremity, motor stimulated potential, lumbosacral magnetic resonance imaging,neurological examination, preoperational and post-operational motor stimulated po-tential in patients with sti spinal cord, electrophysiological conduction studies, the comparison of neurological examination and lumbosacral MRI inspection