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ORIJINAL ARAŞTIRMA

Parkinson Hastalığında Lomber Spinal Stenoz
Lumbar Spinal Stenosis in Parkinson’s Disease
Received Date : 25 Jun 2019
Accepted Date : 02 Oct 2019
Available Online : 03 Oct 2019
Doi: 10.31609/jpmrs.2019-70367 - Makale Dili: EN
J PMR Sci. 2019;22(3):121-5
ÖZET
Amaç: Parkinson hastalığı (PH) hareketi etkileyen progresif bir sinir sistemi bozukluğudur. Son yayınlarda spinal dejeneratif bulgular Parkinson hastalarında sağlıklı kontrollere göre anlamlı olarak daha yüksektir. Omurga deformiteleri ve motor hareket bozuklukları sorumlu tutulmaktadır. Spinal stenoz ve PH yaygın ortak klinik bulgular gösterebilir. Burada, Parkinson hastalığı olan hastalarda Manyetik Rezonans Görüntüleme (MRG)’de, lomber sagittal ve aksiyal spinal çap ölçümleri analiz edilecektir. Gereç ve Yöntemler: Çalışma vaka kontrol olarak planlandı. Son 1 yılda polikliniğe PH tanısı ile başvuran hastalar analiz edildi. Kontrol grubu, benzer yaş (p=0,105) ve cinsiyette (p=0,54) olan sağlıklı gönüllülerden oluşmaktadır. Lumbar MRG’de, L1, L2, L3, L4, L5 spinal kanal çapı ölçümleri tüm hastalara yapıldı ve aksiyal kesitte en dar anteroposterior ve koronal spinal kanal çapı aynı deneyimli klinisyen tarafından ölçüldü. Bulgular: Çalışmaya Parkinson hastalığı olan 63,2±11,9 yaş ortalamasında 50 hasta ve yaş ortalaması 67,2±6,6 yıl olan 41 kontrol hastası alındı. Buna göre lomber sagittal çap L2 (p=0,006), L3 (p=0,008), L5 (p=0,006), aksiyal enine kesit anteroposterior çap (p<0,0001) ve aksiyel kesit koronal çap (p=0,006) ölçümleri sağlıklı kontrollere göre istatistiksel olarak anlamlı düşük bulundu. Sonuç: Çalışmamızda Parkinson hastalarında lomber omurga çap ölçümleri anlamlı olarak düşüktü. Parkinson Hastaların'daki spinal bozukluklar, dejeneratif süreç veya primer hastalık nedeniyle motor etkiden kaynaklanabilir. Ayrıca, hastalık gelişiminde nörodejeneratif patogenez, omurgadaki dejeneratif sürece katkıda bulunabilir.
ABSTRACT
Objective: Parkinson's disease (PD) is a progressive nervous system disorder that affects movement. In recent publications, spinal degenerative findings are significantly higher in patients with PD than healthy controls. Spinal deformities and motor movement disorders are responsible. Spinal stenosis and PD may show common clinical findings. Here, lumbar sagittal and axial spinal for this diameter measurements at Magnetic Resonance Imaging (MRI), will be analyzed in patients with PD. Material and Methods: The study was planned as a case-control study. The patients who were admitted to the outpatient clinic with a diagnosis of PD during the recent year were analyzed. The control group consisted of healthy volunteers with a similar age (p=0.105) and gender (p=0.54). On lumbar MRI, L1, L2, L3, L4, L5 spinal canal diameters were measured in all patients and the narrowest anteroposterior and coronal spinal canal diameter measurements in the axial section were performed by the same experienced clinician. Results: The study included 50 patients with PD with a mean age of 63.2±11.9 years and 41 control patients with a mean age of 67.2 ± 6.6 years. Accordingly, sagittal diameter L2 (p=0.006), L3 (p=0.008), L5 (p=0.006), axial cross-sectional anteroposterior diameter (p<0.001) and axial section coronal diameter (p=0.006) measurements were found significantly low in patient group compared to healthy controls. Conclusion: Lumbar spinal diameter was significantly low in patients with PD. Spinal disorders in PD may be caused by motor effect of degenerative process or primary disease. In addition, neurodegenerative pathogenesis in disease development may contribute to the degenerative process in the spinal canal.
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