AIm: Percutaneous laser disc decompression (PLDD) is a one of the well-known minimal invasive treatment methods of disc herniations. The aim of this study is to present our clinical experience and to show the benefits of this technique. mAterIAl and methOds: A total of 197 patients, who met the criteria of PLDD, underwent treatment between 2007 and 2009. The data of the patients was reviewed retrospectively. Among them, 107 (54.3 %) patients were male and 90 were female with a mean age of 46.34 years (ranged between 23 and 86 years). Seventy-two patients underwent one level PLDD, 112 (56.8 %) patients two levels PLDD and 13 patients three levels PLDD procedures. The mean follow-up time was 42 months. results: Among the 72 patients, the level of PLDD was L3-L4 in 4 patients, L4-L5 in 39 patients and L5-S1 in 29 patients. L4-L5 and L5-S1 levels were the most common 2-level PLDD locations in 71 patients. Twenty-five (12.7 %) patients underwent microsurgical discectomy after PLDD. The procedure was repeated in 3 patients. Discitis secondary to possible thermal injury occurred in 2 (0.1%) patients and this complication was improved with conservative treatment. BulGulAr: 72 hasta içinde, 4 hastada L3-L4 seviyesine, 39 hastada L4-L5 seviyesine ve 29 hastada L5-S1 seviyesine PLDD uygulandı. L4-L5 ve L5-S1 seviyesi en sık 2-seviye PLDD uygulanan seviyedir ve 71 hastaya uygulanmıştır. Yirmibeş (% 12,7) hastaya PLDD'den sonra mikrocerrahi yöntemle diskektomi uygulanmıştır. Üç hastada prosedür tekrar uygulanmıştır. Muhtemel termal hasara sekonder diskitis 2 (% 0,1) hastada izlenmiştir ve bu komplikasyon konservatif yöntemle düzelmiştir. sOnuÇ: Perkütan lazer disk dekompresyonu hasta kriterlere uyduğu takdirde güvenli ve etkin bir tedavi yöntemidir. Ancak bu teknik hiçbir zaman açık cerrahiye alternatif değildir.AnAhtAr sÖZCÜKler: Perkütan lazer disk dekompresyonu, Diskojenik bel ağrısı, Minimal invaziv

AIm:Spinal anesthesia is an appropriate technique for lumbar spine surgeries of two to three hours duration. The aim of this study is to document our experience on spinal anesthesia administered to the patients with degenerative lumbar spine. mAterIAl and methOds: A total of 497 patients underwent spinal stabilization surgery with spinal anesthesia for degenerative lumbar spinal disorders in an 8-year period. Spinal anesthesia was performed at the L3-L4 or L4-L5 level and subarachnoid block was achieved with 15 mg of 0.5% plain bupivacaine with 2 µg of fentanyl and 0.2 mg of epinephrine. There was no failure of anesthesia. The patients were closely monitored for complications associated with the SA technique and especially hypotension and bradycardia but no gross alterations in cardiovascular stability were noted. results: Among the 497 patients, 139 were male and 358 were female with a median age of 51 years. The average anesthesia duration was 130 minutes and the average operative time was 85 minutes. In the postoperative period 36 patients has nausea (7.2%) and 18 of them had vomiting (3.6%) that required one dose of antiemetic. No spinal headache was observed and 36 (7.2%) patients complained of urinary retention. All recovered with urinary cannulation within 24 hours. No respiratory complication occurred and no patient died.COnClusIOn: Spinal anesthesia is a safe and effective procedure for the lumbar spinal stabilization surgery, especially in high-riskpatients. Proper precautions should be taken in order to achieve an effective anesthesia for these operations. BulGulAr: Toplam 497 hastanın 139 tanesi erkek, 358 tanesi ise bayandı ve ortalama yaş 51 idi. Ortalama anestezi süresi 130 dakika ve ortalama ameliyat süresi ise 85 dakika olarak hesaplandı. Postoperatif dönemde 36 (%7,2) hastada bulantı oldu ve bunların 18 (%3,6) tanesinde kusma görüldü. Bir doz antiemetik ile düzeldi. Spinal anesteziye bağlı başağrısı hiçbir hastada görülmedi ancak 36 (%7,2) hastada üriner retansiyon görüldü ve bu da 24 saat içinde üriner kanülasyon ile düzeldi. Solunum sıkıntısı görülmedi ve hiçbir hasta ölmedi. sOnuÇ: Spinal anestezi özellikle yüksek riskli hasta grubunda lomber stabilizasyon cerrahisi için güvenli ve etkili bir yöntemdir. Bu tür ameliyatlarda etkin anestezinin sağlanması için uygun tedbirlerin alınması gereklidir.

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ABSTRACTemphasize the uneventful follow-up period against warnings of thermal injury of the brain tissue due to the PMMA graft.

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