Gergin omurilik sendromlu hastalarda preop ve postop motor uyarılmış potansiyel, elektrofizyolojik iletim çalışmaları,nörolojik muayene ve lumbosakral MRG tetkiklerinin karşılaştırılması
Pre-operational and post-operational motor stimulated potential, electrophysiological conduction studies in patients with tethered cord syndrome, neurological examination and comparison of lumbosacral MRG investigations
Yazar: ÜMMÜ SERPİL SARI
Danışman: PROF. DR. DENİZ SELÇUKİ
Celal Bayar Üniversitesi / Tıp Fakültesi / Nöroloji Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2013
Konu: Nöroloji = Neurology
Dizin: Bacak = Leg ; Elektrofizyoloji = Electrophysiology ; Manyetik rezonans görüntüleme = Magnetic resonance imaging ; Nörolojik muayene = Neurologic examination ; Spinal kord hastalıkları = Spinal cord diseases ; Uyarılmış potansiyeller = Evoked potentials

Özet:
Gergin omurilik sendromu (GOS), omuriligin mekanik gerilmesine bagl olarak alt
ekstremitelerde hareket, duyu bozukluklar ve idrar-gayta inkontinans gibi ilerleyici
norolojik belirti ve bulgular ile ortaya ckan; sklkla kas ve iskelet sistemi sekil bo-
zukluklarnn eslik ettigi bir klinik tablodur. [1, 8] Dogumsal veya edinsel nedenlerle
gelisebilen bu sendromda, embriyolojik donemde norulasyon kusuru sonucu ortaya
ckan, miyelomeningosel, lipomiyelomeningosel, dermal sinus traktusu, ayrk omurilik
malformasyonu (AOM) ya da kuyruk tomurcugunun kanalizasyon kusuru sonucu or-
taya ckan terminal miyelosistosel ve gergin lum terminale gibi hastalklar dogumsal
(primer) GOS nedenlerini olusturur.
Gecirilmis miyelomeningosel, spinal tumor gibi ameliyatlarn ardndan ya da spinal
travma sonras olusabilecek yapsklklar da edinsel (sekonder) gergin omurilik send-
romu nedeni olabilir. GOS tans klinik olarak konulur.Goruntuleme yontemleri, so-
matosensoryel uyarlms potansiyeller (SEP) ve urodinami tanya yardmc yontem-
lerdir.GOS'un belirlenmesinde en onemli radyolojik tan arac lumbosakral manyetik
rezonans goruntulemedir (MRG). [4, 5, 7, 29, 53, 64]
Bu calsmamzda, kesin GOS tans bulunan, 18 yas uzeri 20 hastada preop ve post-
op klinik, lumbosakral MRG, elektrozyolojik iletim ve motor uyarlms potansiyel
(MUP) sonuclar karslastrlmstr.
Anahtar Kelimeler: Gergin omurilik sendromu, alt ekstremite elektrozyolojik iletim calsmalar, Motor uyarlms Potansiyel, Lumbosakral Manyetik rezonans goruntuleme,norolojik muayene

Abstract:
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 together
with progressive neurological symptoms and ndings such as movement, sensory im-
pairments, and incontinence in lower extremities depending on mechanical regression
of the spinal cord, often accompanied with muscle and skeletal system malformations.
[1, 8] Diseases such as terminal myelocystocele and sti lumterminale occurring as
a result of canalization impairment of the caudal bud or myelomeningocele, lipomye-
lomeningosel, dermal sinus tractus, split spinal cord malformation (SCM) occurring
as a result of neurulation impairment in embryologic period in this syndrome that
may 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 methods
are helpful in TCS diagnosis such as radiological studies, somatosensory evoked po-
tentials (SEP) and urodynamics study. The most important radiological diagnosis
tool 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 preoperational
and post-operational clinical imaging in 20 patients over 18 years old diagnosed with
denitive TCS. We aimed at contributing to the literature and our university with
the results to be obtained in the light of abovementioned information in this study
due 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