GH deficiency (GHD) was the most common pituitary deficit at 12 months after SAH and the majority of the patients (87.5%) had isolated GHD. During the 12-month follow-up, pituitary function was found to either improve or worsen in a considerable number of patients.
Subarachnoid haemorrhage (SAH) is known to be related to pituitary dysfuntion in retrospective and short-term prospective studies. We aimed to investigate pituitary functions in patients with SAH in longer follow-up periods to demonstrate if pituitary hormone deficiencies recover, persist or new hormone deficiencies occur. Twenty patients with SAH, who were followed up for 3 years, were included in the present study. Patients were evaluated with basal hormone levels and glucagon stimulation test (GST).Serum basal cortisol and adrenocorticotropic hormone (ACTH) levels were found to be significantly elevated at 3rd year of SAH compared to 1st year. Other basal hormone levels at 3rd year did not show a significant change from the levels found at 1st year. One of the patients had ACTH deficiency at 1st year of SAH and recovered at 3rd year. Growth hormone (GH) deficiency, according to GST,was diagnosed in 4 patients. One patient with GH deficiency at first year was still deficient, 3 of them recovered and 3 patients were found to have new-onset GH deficiency 3 years after SAH. SAH is associated with anterior pituitary dysfunction and GH is the most frequently found deficient hormone in the patients. Although one year after SAH seems to be an appropriate time for the evaluation of pituitary functions, further follow-up may be required at least in some cases due to recovered and new-onset hormone deficiencies at 3rd year of SAH.
AIm: Bilateral decompression via unilateral approach is one of the minimally invasive methods used for degenerative spinal stenosis. The aim of this retrospective study was to observe the clinical and radiological results of classic laminectomy and bilateral decompression via unilateral approach applied for lumbar stenosis.
mATERIAl and mEThods:The data of 40 patients who underwent surgical treatment for lumbar spinal stenosis with different techniques was reviewed retrospectively. The patients were divided into 2 groups according to the surgical technique. In the first group, patients underwent classic laminectomy, while in the second group patients underwent bilateral decompression via unilateral approach. Preoperative and postoperative computed tomography section areas of both groups were examined. Visual analogue scale (VAS) was used to evaluate low back and leg pain in preoperative and postoperative 1, 6, and 12 months. The two groups were compared in respect of surgery time and bleeding.
REsulTs:In both groups, postoperative low back and leg pain VAS scores declined compared to the preoperative condition. Low back pain VAS scores were lower at postoperartive 1, 6, and 12 months. The bleeding was higher in the 1st group, whereas the surgery time was higher in the 2nd group.CoNClusIoN: Bilateral decompression through unilateral approach is an effective method without instability effect, which provides sufficient decompression in the degenerative stenosis and increases patient comfort in the postoperative period.KEywoRds: Lumbar stenosis, Unilateral approach, Minimally invasive ÖZ AmAÇ: Dejeneratif lomber dar kanalda kullanılan minimal invaziv yöntemlerden bir tanesi tek taraflı girişimle iki taraflı dekompresyondur. Bu retrospektif çalışmada, klasik laminektomi ile tek taraflı girişimle iki taraflı dekompresyon sağlanan lomber dar kanal hastalarının klinik ve radyolojik sonuçlarını karşılaştırdık. yÖNTEm ve GEREÇlER: Lomber stenoz tanısı olan ve farklı tekniklerle opere edilen 40 hastanın verileri retrospektif olarak değerlendirildi. Hastalar uygulanan cerrahi tekniğe göre 2 ayrı gruba ayrıldı. Birinci gruptaki hastalar klasik laminektomi uygulanan hastalar iken, ikinci gruptaki hastalar ise tek taraflı girişimle iki taraflı dekompresyon yapılan olgulardı. Her iki grup için ameliyat öncesi ve sonrası aksiyel bilgisayarlı tomografi görüntüleri elde edildi. Hastaların bel ve bacak ağrıları 1. ayda, 6. ayda ve 12. ayda vizüel analog skalası (VAS) ile değerlendirildi. Her iki grup ameliyat süresi ve kanama miktarı ile de karşılaştırıldı.BulGulAR: Her iki grupta da ameliyat sonrası bel ve bacak ağrıları için VAS değerlerinde azalma görüldü. İkinci grup için bel ağrısı VAS değerleri 1. ayda, 6. ayda ve 12. ayda birinci gruba göre düşüktü. Kanama miktarı birinci grupta daha fazlayken ameliyat süresi ikinci grupta daha fazlaydı. soNuÇ: Tek taraflı girişimle iki taraflı dekompresyon lomber dar kanal hastalarında kullanılan minimal invaziv, instabilite yaratmadan yeterli dekompresyon sağlayan ve hastanın cerra...
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