Spinal Dekompresyon

Değişen hayat koşullarının bir sonucu olarak, bel ve boyun ağrıları günümüzde en çok karşılaşılan sağlık problemlerinden biri haline gelmiştir. Bel ve boyun ağrılarının tedavisinde temel hedef, hastalara cerrahisiz, uzun süreli bir iyileşme sağlamaktır.

DRX9000, bel ve boyun fıtığı (disk hernisi), dejeneratif  disk hastalığı, siyatalji gibi omurgaya bağlı rahatsızlıkların tedavisinde hastalara cerrahisiz iyileşme olanağı sunan, yüksek başarı oranına sahip yeni bir teknolojidir.

DRX9000 bel ve boyun ağrısına neden olan anatomik yapılar üzerindeki basıyı kaldırarak, orada negatif  basınç oluşturup diskin yerine oturmasını (repozisyon) sağlamaktadır. Meydana gelen negatif basınç, hasarlı bölgenin kanlanmasını ve sıvı akışını arttırarak bölgenin iyileşmesini hızlandırmaktadır.

Hastanın tedavideki güvenlik ve konforunu ön planda tutan DRX9000 sistemleri sayesinde, bel ve boyun ağrılarınızdan kurtularak yaşam kalitenizi arttırabilirsiniz.

D-70 Clinical Case Slide - Spine II Thursday, June 2, 2016, 3:15 PM - 4:35 PM Room: 203 2332 Chair: Gary P. Chimes. Lake Washington Sports & Spine, Bellevue, WA. (No relationships reported) 2333 Discussant: Joseph Ihm, FACSM. Rehabilitation Institute of Chicago, Chicago, IL. (No relationships reported) 2334 June 2, 3:15 PM - 3:35 PM Low Back Injury Nevin Ergun, FACSM1, Aynur Demirel1, Elif Özkaleli2, Mehmet Yörübulut3. 1hacettepe university, ankara, Turkey. 2Private Fonksiyon Physical Therapy Center, ankara, Turkey. 3Acıbadem Hospital, ankara, Turkey. Email: nergun@hacettepe.edu.tr (No relationships reported)

HISTORY: A 34-year-old woman has severe back and radiating right leg pain applied to our clinic. This was the second time coming to our clinic. When she came fist, she applied with back and radiating pain to both legs. As to Magnetic Resonance Imagination (MRI) she had tear of annulus lomber 4 and 5 level intervertebral disc and severely bilaterally narrowed neural canal. A large, posterior median and right paramedian extrude disc protrusion was seen at L5-S1 level. At this level bilateral nerve canal narrowed and right S1 nerve root was compressed. After 21 sessions of non-invasive spinal decompression therapy applied, her pain was over. One week ago, after she weighted heavy bags, she felt back pain again. PHYSICAL EXAMINATION: Paravertebral and right quadratus lumborum muscle spasm were palpated. Straight leg raise test were positive at 60° on right side. Valleix sign was positive on right sciatic nerve. There was no strenght and sensorial deficit. Lumbar lordosis decreased and lumbar “C” shaped scoliosis were noted. DIFFERENTIAL DIAGNOSIS: Strain of lumbar paravertebral muscles Radiating pain Positive sciatic nerve provacation test TEST AND RESULTS: Lumbar spine T1 and T2 weighted MRI: − Posterior protrusion and annular tear at lumbar 4-5 level (annular tear and protrusion still exists) − Broad-based posterocentral and right posterolateral transligamentous extrude herniation (extrude fragment’s volume decreased from 12 mm to 8 mm comparing the first MRI) FINAL/WORKING DIAGNOSIS: Lumbar Disc Herniation (L5- S1 and L4-L5 level) TREATMENT AND OUTCOMES: − 21 sessions of Non-invasive Spinal Decompresion Therapy conservative protokol applied. − During the first two weeks of therapy, lumbar orthoses was used to stabilization. − Physiotherapist guided lumbar stabilization exercise applied to prevent reherniation (after non-invasive spinal decompression therapy was over). − Advanced lumbar stabilization exercised taugth as home programme. − After therapy she has painless straight leg raise test and no radiating pain.

2335 June 2, 3:35 PM - 3:55 PM Sacrum Injury Özlem Güven Ülger, Aynur Demirel, Altan Şahin. Hacettepe University, Ankara, Turkey. Email: ozlemulger@yahoo.com (No relationships reported) HISTORY: A 44-year-old secretary fell down from 4 meter above from the ground. After detailed physical and neurologic examination she had fixation operation due to fracture of left sacrum and pubic bones. While staying at the hospital , she had an decubitus ulceration on left sacroiliac joint and posterior inferior iliac spine. In spite of decubitus ulceration needed flapping, she rejected operatively treatment. After decubitus ulceration healed itself, she had pain on right side of sacrum and she had an corticostreoid injection on right sacroiliac joint. After injection, pain decreased but still exists. PHYSICAL EXAMINATION: Examination of paravertebral muscles and T12- L5 spinos processes pain and moderate tenderness detected. There was no numbness, allodynia and reflex deficits. Both flexion and extension movements of back were painful. active lomber flexion, her hands reached knee level. She could not sit symetrically. When she sits longer than ten minutes, she felt severe pain on sacrum. DIFFERENTIAL DIAGNOSIS: − Strain of paravertebral, piriformis and Quadratus Lumborum muscles. − Sacroiliac dysfunction − Facet Joint Syndrome TEST AND RESULTS: − Special provocation tests for sacroiliac joint − Lomber facet Joint stress tests − Pressure Pain Thresholds − Back Performance Scale TREATMENT AND OUTCOMES: − Myofascial releasing technics applied to muscles and thoracolomber fascia. − Post-isometric relaxation technics for Piriformis and Quadratus Lumborum muscles on right side. − Physiotherapist guided lomber stabilization exercise − Kinesiotaping application for scar tissue on decubitus ulceration area. − After 4 months later she had painless sitting, standing and walking abilities.

  Hacettepe üniversitesi ‘nde yapılan doktora tezi çalışması ve yayınlarıdır.