Beyin ve Sinir Cerrah\u0131 Op. Dr. Kemal Ke\u015fmer, bel f\u0131t\u0131klar\u0131n\u0131n y\u00fczde 2\u2019sinin ameliyat gerektirdi\u011fini ve ameliyat olanlar\u0131n ise y\u00fczde 5 oran\u0131nda f\u0131t\u0131\u011f\u0131n tekrarlama riskinin oldu\u011funu s\u00f6yledi.<\/p>\n
VM Medical Park Kocaeli Hastanesi\u2019nde Beyin ve Sinir Cerrah\u0131 Op. Dr. Kemal Ke\u015fmer, bel f\u0131t\u0131\u011f\u0131n\u0131n belirtileri hakk\u0131nda bilgiler verdi. Bel f\u0131t\u0131\u011f\u0131n\u0131n en \u00f6nemli belirtisinin bel ve bacak a\u011fr\u0131s\u0131 oldu\u011funu belirten Ke\u015fmer, bel f\u0131t\u0131\u011f\u0131ndan korunman\u0131n yollar\u0131 ve bel f\u0131t\u0131\u011f\u0131n\u0131n tedavi s\u00fcrecini anlatt\u0131. Ke\u015fmer, \u201cBa\u015flang\u0131\u00e7ta belde ba\u015flayan a\u011fr\u0131 daha sonra giderek baca\u011fa yay\u0131l\u0131r. Bu a\u011fr\u0131 genellikle tek tarafl\u0131d\u0131r ancak iki tarafl\u0131 da olabilir. Bazen hastalar yaln\u0131zca bacak a\u011fr\u0131s\u0131 ile gelir. Ani bir zorlanma ya da ters hareketle a\u011fr\u0131 birden ba\u015flayabilir. Genellikle a\u011fr\u0131 daha \u00f6nce birka\u00e7 defa tekrarlam\u0131\u015ft\u0131r, tedaviyle ya da kendili\u011finden d\u00fczelmi\u015ftir. Hastada ayr\u0131ca bacakta uyu\u015fma, bel hareketlerinde k\u0131s\u0131tlama g\u00f6r\u00fclebilir. \u00d6ks\u00fcrme, hap\u015f\u0131rma, uzun s\u00fcreli oturma, a\u011f\u0131r y\u00fck kald\u0131rma, otomobil kullanma, \u00f6ne do\u011fru e\u011filme, stres, so\u011fukta kalma a\u011fr\u0131y\u0131 artt\u0131r\u0131r\u201d dedi.<\/p>\n
Bel f\u0131t\u0131\u011f\u0131n\u0131n olu\u015fma mekanizmas\u0131 hakk\u0131nda bilgiler aktaran Op. Dr. Kemal Ke\u015fmer, \u201cKafatas\u0131n\u0131n alt\u0131nda enseden ba\u015flay\u0131p kuyruk sokumumuzun ucuna kadar omurilik kanal\u0131n\u0131 olu\u015fturan 31 adet omur vard\u0131r. Bu omurlardan be\u015f tanesi bel b\u00f6lgesinde bulunur. Bu omur kemiklerinin aras\u0131nda hareketi sa\u011flayan ve darbelere kar\u015f\u0131 koruyucu g\u00f6rev yapan disk \u015feklinde \u00f6zel bir k\u0131k\u0131rdak bulunur. Bu disk i\u00e7 ve d\u0131\u015f tabaka olmak \u00fczere iki k\u0131s\u0131mdan olu\u015fur. D\u0131\u015ftaki tabakan\u0131n yap\u0131s\u0131 bozulunca i\u00e7te bulunan yumu\u015fak tabaka d\u0131\u015far\u0131ya do\u011fru ta\u015far. Bu ta\u015fan (f\u0131t\u0131kla\u015fan) k\u0131s\u0131m omurilik kanal\u0131ndaki omurili\u011fe ve omurilikten \u00e7\u0131kan sinirlere bask\u0131 yapar ve bu sinirleri s\u0131k\u0131\u015ft\u0131r\u0131r. Bel b\u00f6lgesi omurgan\u0131n hareketli b\u00f6lgesi oldu\u011fundan ve en \u00e7ok y\u00fck ta\u015f\u0131yan b\u00f6l\u00fcm\u00fc oldu\u011fundan bu b\u00f6lge f\u0131t\u0131kla\u015fman\u0131n en \u00e7ok g\u00f6r\u00fcld\u00fc\u011f\u00fc b\u00f6lgedir. Bu \u015fekilde ortaya \u00e7\u0131kan hastal\u0131\u011fa bel f\u0131t\u0131\u011f\u0131 denir\u201d diye konu\u015ftu.<\/p>\n
Bel f\u0131t\u0131\u011f\u0131 kimlerde g\u00f6r\u00fcl\u00fcr?<\/p>\n
Oturarak \u00e7al\u0131\u015fan ki\u015filerde bel f\u0131t\u0131\u011f\u0131 g\u00f6r\u00fclme ihtimalinin y\u00fcksek oldu\u011funu ifade eden Beyin ve Sinir Cerrahi Op. Dr. Ke\u015fmer \u015funlar\u0131 s\u00f6yledi: \u201cToplumun y\u00fczde 80\u2019inden fazlas\u0131n\u0131n en az hayat\u0131nda bir kere bel a\u011fr\u0131s\u0131 \u00e7ekti\u011fi bilinmektedir. Bel ve bacak a\u011fr\u0131s\u0131 ile hekime ba\u015fvuranlar\u0131n say\u0131s\u0131 olduk\u00e7a fazlad\u0131r. S\u0131kl\u0131kla orta ya\u015flarda g\u00f6r\u00fcl\u00fcr fakat her ya\u015fta ortaya \u00e7\u0131kabilir. Oturarak \u00e7al\u0131\u015fan ki\u015filerde bel f\u0131t\u0131\u011f\u0131 g\u00f6r\u00fclme ihtimali y\u00fcksektir. A\u011f\u0131r y\u00fck kald\u0131rmak zorunda olanlar, spor yaparken dikkatsiz davrananlar, egzersize \u0131s\u0131nmadan ba\u015flayanlar, duru\u015f ve oturma bozuklu\u011fu olanlar risk alt\u0131ndad\u0131r. Kontrols\u00fcz ve dengesiz olarak e\u011filerek y\u00fck kald\u0131rma en s\u0131k kar\u015f\u0131la\u015f\u0131lan nedendir. Bel f\u0131t\u0131\u011f\u0131 titre\u015fimli ara\u00e7 kullananlar ve \u015fof\u00f6rlerde s\u0131k g\u00f6r\u00fcl\u00fcr. Sigara ve alkol kullan\u0131m\u0131 da bel f\u0131t\u0131\u011f\u0131n\u0131 tetikleyebilir. Stres, obezite, ge\u00e7irilmi\u015f travmalar, ailesel yatk\u0131nl\u0131k, sistemik hastal\u0131klar, kemik erimesi di\u011fer risk fakt\u00f6rleridir. Bu risklere ne kadar \u00e7ok maruz kal\u0131yorsan\u0131z bel f\u0131t\u0131\u011f\u0131 olma ihtimaliniz de o kadar fazlad\u0131r.\u201d<\/p>\n
“Her bel a\u011fr\u0131s\u0131 bel f\u0131t\u0131\u011f\u0131 de\u011fildir”<\/p>\n
Bel f\u0131t\u0131\u011f\u0131 te\u015fhisinde hastal\u0131\u011f\u0131n hikayesi ile muayenenin \u00f6nemine de de\u011finen Dr. Ke\u015fmer, \u201cHer bel a\u011fr\u0131s\u0131 bel f\u0131t\u0131\u011f\u0131 de\u011fildir. Kanser, romatizma, bel kaymas\u0131, enfeksiyonlar, b\u00f6brek ta\u015flar\u0131, kal\u00e7a eklem hastal\u0131klar\u0131, omurga k\u0131r\u0131klar\u0131 spor yaparken belini incitmek gibi bir\u00e7ok sorun bel f\u0131t\u0131\u011f\u0131 gibi belirtiler verir. Bu y\u00fczden te\u015fhis koyarken dikkatli olmak gerekir. Bel f\u0131t\u0131\u011f\u0131 te\u015fhisinde hastan\u0131n anamnezi (hastal\u0131\u011f\u0131n\u0131n hikayesi) ve muayene \u00f6nemlidir. Tan\u0131y\u0131 kesinle\u015ftirmek i\u00e7in bilgisayarl\u0131 bel tomografisi ya da daha s\u0131kl\u0131kla bel MR\u2019\u0131 \u00f6nemli bir yer tutmaktad\u0131r. Bu y\u00f6ntemlerle sorunun nerede ve hangi dokuda oldu\u011fu kolayl\u0131kla tespit edilir. Ayr\u0131ca bilgisayarl\u0131 tomografi kemi\u011fin durumunu daha iyi ortaya koydu\u011fu i\u00e7in baz\u0131 durumlarda tercih edilebilir. B\u00f6ylece hastan\u0131n \u015fikayeti, bu \u015fikayetin hikayesi, \u00f6z ge\u00e7mi\u015fi, fizik muayene bulgular\u0131, radyolojik tetkikler (grafi, tomografi, MR), laboratuvar tetkikleri ile kesin tan\u0131 konulur\u201d diye konu\u015ftu.<\/p>\n
Bel f\u0131t\u0131\u011f\u0131n\u0131n tedavisi<\/p>\n
Bel f\u0131t\u0131\u011f\u0131n\u0131n tedavisinde \u00f6ncelikle konservatif tedavi denen ila\u00e7 kullan\u0131m\u0131, istirahat, sert bir yatakta yatmak, korse kullanmak ve fizik tedavi gibi y\u00f6ntemler uyguland\u0131\u011f\u0131n\u0131 belirten Kemal Ke\u015fmer, \u201cBunlar bir\u00e7ok bel f\u0131t\u0131\u011f\u0131 hastal\u0131\u011f\u0131n\u0131n d\u00fczelmesini sa\u011flar. Kas gev\u015fetici, a\u011fr\u0131 kesici ila\u00e7lar ve merhemler; b vitamini, k\u0131k\u0131rdak yenileyici \u00fcr\u00fcnler tercih edilir. Akut d\u00f6nemde istirahat \u00f6nerilirken, kronik d\u00f6nemlerde hastaya egzersiz yapmas\u0131 \u00f6nerilir. Burada \u00f6nemli olan nokta hastan\u0131n n\u00f6rolojik muayenesi, MR bulgular\u0131, \u015fikayetlerin s\u00fcresi, daha \u00f6nce hangi tedavilerin uyguland\u0131\u011f\u0131 ve hastan\u0131n \u00e7ekti\u011fi \u0131zd\u0131rab\u0131n derecesidir. E\u011fer bacaklarda g\u00fc\u00e7s\u00fczl\u00fck geli\u015fiyorsa, idrar tutam\u0131yorsa ve bunu bel MR\u2019\u0131nda a\u00e7\u0131klayan sinir bas\u0131s\u0131 varsa acil ameliyat olmak gerekir. Bunun d\u0131\u015f\u0131nda alt\u0131 haftadan fazla s\u00fcren \u015fiddetli a\u011fr\u0131larda, di\u011fer konservatif tedavilere yan\u0131t vermeyen, g\u00fcnl\u00fck ya\u015fant\u0131dan al\u0131koyan \u015fiddetli a\u011fr\u0131larda cerrahi tedavi d\u00fc\u015f\u00fcn\u00fcl\u00fcr. Modern t\u0131p a\u00e7\u0131s\u0131ndan da bel f\u0131t\u0131\u011f\u0131nda yeni geli\u015fmeler s\u00f6z konusudur. \u0130stirahat, korse, ila\u00e7 tedavisi d\u0131\u015f\u0131nda algolojik tedaviler s\u00f6z konusudur. Belden omurilik kanal\u0131na s\u0131k\u0131\u015fan sinirin \u00fczerine yap\u0131lan direkt ila\u00e7 uygulamalar\u0131, f\u0131t\u0131kla\u015fan diskin lazerle yak\u0131lmas\u0131, k\u00f6k h\u00fccre tedavileri gibi yeni uygulamalar vard\u0131r. G\u00fcn\u00fcm\u00fczde alternatif tedavi y\u00f6ntemleri h\u0131zla geli\u015fmektedir. Manip\u00fclasyon tedavileri, akupunktur, ozon tedavisi, proloterapi, biyoenerji, hacamat, s\u00fcl\u00fck tedavileri bir\u00e7ok alternatif y\u00f6ntem bel f\u0131t\u0131klar\u0131nda kullan\u0131lmaktad\u0131r\u201d dedi.<\/p>\n
“V\u00fccudun yap\u0131s\u0131na ters gelen, zorlay\u0131c\u0131 hareketlerden ka\u00e7\u0131n\u0131lmal\u0131”<\/p>\n
Hareketsiz bir ya\u015fam tarz\u0131ndan uzak durmak ve bel kaslar\u0131n\u0131 g\u00fc\u00e7lendirici egzersizlerin faydas\u0131ndan bahseden Dr. Ke\u015fmer, \u201c\u00d6nemli olan hastal\u0131\u011fa yakalanmadan \u00f6nce gerekli olan tedbirleri alarak bel f\u0131t\u0131\u011f\u0131 riskini en aza indirmektir. Bunun i\u00e7in a\u011f\u0131r y\u00fck kald\u0131rmamaya \u00f6zen g\u00f6stermek gerekir. V\u00fccudun yap\u0131s\u0131na ters gelen, zorlay\u0131c\u0131 hareketlerden ka\u00e7\u0131n\u0131lmal\u0131d\u0131r. Beli kullanarak e\u011filmek yerine \u00e7\u00f6melip yani dizlerimizi k\u0131r\u0131p e\u011filmek, bir yerden bir \u015fey al\u0131rken olabildi\u011fince alaca\u011f\u0131m\u0131z cisme yakla\u015fmak gerekir. \u0130\u015f yerinde beli zorlayacak v\u00fccut post\u00fcrlerine (ergonomiye) dikkat edilmelidir. Hareketsiz bir ya\u015fam tarz\u0131ndan uzak durmak ve bel kaslar\u0131n\u0131 g\u00fc\u00e7lendirici egzersizler \u00e7ok faydal\u0131d\u0131r. Y\u00fczme, yoga, pilates bel a\u011fr\u0131lar\u0131ndan korunmak i\u00e7in ideal sporlard\u0131r. Ata binmek, bisiklete binmek, tenis ise bel f\u0131t\u0131\u011f\u0131 olu\u015fmas\u0131na neden olabilir. Stresten uzak durmak, iyi \u0131s\u0131nmadan spor yapmamak \u00e7ok \u00f6nemlidir. Sigara ve a\u015f\u0131r\u0131 kilodan uzak durulmal\u0131d\u0131r\u201d diye konu\u015ftu.<\/p>\n
Bel f\u0131t\u0131\u011f\u0131nda ameliyat olmal\u0131 m\u0131y\u0131z?<\/p>\n
Bel f\u0131t\u0131klar\u0131n\u0131n ancak y\u00fczde 2\u2019sinin ameliyat gerekti\u011fini vurgulayan Beyin ve Sinir Cerrah\u0131 Op. Dr. Kemal Ke\u015fmer, \u201cTabii ki \u00f6ncelikle kendimizi korumal\u0131 ve f\u0131t\u0131k olmamal\u0131y\u0131z. Ancak f\u0131t\u0131k olduktan sonra bir s\u00fcr\u00fc tedavi se\u00e7ene\u011fimiz mevcut. Bel f\u0131t\u0131klar\u0131n\u0131n ancak y\u00fczde 2\u2019si ameliyat gerektirir. E\u011fer \u00e7ok \u0131zd\u0131rap \u00e7ekmiyorsak ve n\u00f6rolojik defisit (bacaklarda g\u00fc\u00e7s\u00fczl\u00fck, idrar tutamama gibi) yoksa alternatif tedavileri deneyebiliriz. Ameliyat\u0131 en son se\u00e7enek olarak d\u00fc\u015f\u00fcnmeliyiz. Ameliyat olanlar\u0131n y\u00fczde 5 oran\u0131nda f\u0131t\u0131\u011f\u0131n tekrarlama riski mevcuttur. Art\u0131k mikrocerrahi ile ameliyat riskleri, \u00f6zellikle ameliyata ba\u011fl\u0131 bacaklarda g\u00fc\u00e7s\u00fczl\u00fck geli\u015fmesi \u00e7ok nadirdir. Bacaklarda g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fc olan, idrar ve gaita problemi olanlarda ameliyattan ka\u00e7\u0131nmak hastalar i\u00e7in \u00e7ok b\u00fcy\u00fck tehlike olu\u015fturmaktad\u0131r. \u00c7\u00fcnk\u00fc kal\u0131c\u0131 olarak \u00f6m\u00fcr boyu bacaklar\u0131nda ve ayaklar\u0131nda g\u00fc\u00e7s\u00fczl\u00fckle (fel\u00e7le) idrar ve gaitas\u0131n\u0131 tutamamadan ya\u015famak zorunda kalabilirler. Bel f\u0131t\u0131\u011f\u0131nda cerrahi ilk se\u00e7enek olmamakla birlikte, bu durumlarda ilk se\u00e7enek olmal\u0131d\u0131r. Son s\u00f6z olarak bel f\u0131t\u0131\u011f\u0131n\u0131n kesin tan\u0131s\u0131 ve bir fel\u00e7 riski olu\u015fturup olu\u015fturmad\u0131\u011f\u0131n\u0131 belirlemek i\u00e7in \u00f6ncelikle beyin cerrahisine muayene olunmal\u0131d\u0131r. E\u011fer bir fel\u00e7 riski olu\u015fturmuyorsa alternatif tedaviler denenir. Ama di\u011fer tedavi y\u00f6ntemleri ile tedavi olunam\u0131yorsa ya da yukar\u0131da belirtilen tehlikeli durumlarda cerrahi tedavi \u00f6nerilir\u201d \u015feklinde konu\u015ftu.<\/p>\n","protected":false},"excerpt":{"rendered":"
BEY\u0130N VE S\u0130N\u0130R CERRAH\u0130 OP. DR. KEMAL KE\u015eMER, BEL FITIKLARININ Y\u00dcZDE 2\u2019S\u0130N\u0130N AMEL\u0130YAT GEREKT\u0130RD\u0130\u011e\u0130N\u0130 VE AMEL\u0130YAT OLANLARIN \u0130SE Y\u00dcZDE 5 ORANINDA FITI\u011eIN TEKRARLAMA R\u0130SK\u0130N\u0130N OLDU\u011eUNU S\u00d6YLED\u0130.<\/p>\n","protected":false},"author":1,"featured_media":165172,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[1],"tags":[2311,571,8690,2771,279,39299,39300,640,39298,17415,3480],"class_list":["post-165171","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-2si","tag-ameliyat","tag-ancak","tag-bel","tag-dr","tag-fitiklarinin","tag-gerektirir","tag-kemal","tag-kesmer","tag-op","tag-yuzde"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.tvturk.com\/wp-content\/uploads\/2019\/06\/op-dr-kemal-kesmer-bel-fitiklarinin-ancak-yuzde-2si-ameliyat-gerektirir_75a036d.jpg?fit=1000%2C1000","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/paKIfm-GY3","_links":{"self":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/165171","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/comments?post=165171"}],"version-history":[{"count":0,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/165171\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media\/165172"}],"wp:attachment":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media?parent=165171"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/categories?post=165171"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/tags?post=165171"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}