Hasta Öyküsü

For the past eight years, hasta yürürken ve dönerken lomber omurgada ağrıdan ve oturma pozisyonundan kalkarken şikayet ediyordu. Ağrı sıklıkla bacaklara yayılıyordu, especially to the left leg, with a girdle-like character.

The patient constantly experienced dull lumbar pain ve her iki bacağın dış tarafında uyuşma, özellikle solda belirgin. Yıllarca süren konservatif tedavi kalıcı iyileşme sağlayamadı. Önerilen spinal füzyon ile stabilizasyon cerrahisi hasta tarafından reddedildi.

Tanı

  • Degeneration and circumferential disc protrusion L3/L4
  • Deformative degeneration of L4/L5, L5/S1 discs — pronounced destruction with shape alteration
  • Spondylolisthesis with L4 vertebral ventralization — anterior vertebral body displacement
  • Circumferential stenosing central-lateral protrusion L4/L5 — caused by spondylolisthesis
  • Absolute foraminal stenosis L5/S1 — complete nerve canal closure
  • Destabilization of L4/L5, L5/S1 segments — loss of spinal column stability
  • Bilateral facet joint arthrosis L3/L4, L4/L5, L5/S1 — degeneration at three levels

Two-Stage Treatment — MIBRAR® Method

First Procedure — 29.02.2016

Intradiscal and intra-articular transplantation of autologous concentrates into L4/L5, L5/S1 segments:

  • CGF (Concentrated Growth Factors) — enriched with platelets, growth factors, and anti-inflammatory factors (from venous blood)
  • Lipogems® (microfragmented adipose tissue) — with high concentration of regenerative substances (from subcutaneous adipose tissue)
  • Injection sites: intradiscally into L4/L5 and L5/S1, intra-articularly into facet joints at both levels

Second Procedure — 20.04.2017 (after 14 months)

Rejeneratif etkiyi güçlendirmek ve pekiştirmek için aynı protokolle tekrar intradiskal ve intraartiküler transplantasyon:

  • Repeat CGF and Lipogems® implantation into L4/L5, L5/S1 discs
  • Goal: further disc height increase, structural reinforcement, and full repositioning of displaced L4 vertebra

Radiological Follow-up — Reconstruction Stages

Sagittal ve frontal görünümlerde bir dizi röntgen, aşamalı disk rekonstrüksiyonunu belgeler: preoperatif → intermediate result → final intraoperative result → 10-week follow-up → 14-month follow-up → 3-month follow-up after the second procedure.

X-ray: intradiscal MIBRAR® transplantation L5/S1 — before and after, sagittal view
L5/S1 — sagittal view: Sol — implantasyon öncesi spinal sonda yerleştirme. Sağ — transplantasyon sonrası: işlem sonrası hemen belirgin L5/S1 disk yüksekliği artışı.
X-ray: 10-week and 14-month follow-up — L5/S1 disc height increase
L5/S1 — 10-week and 14-month follow-up: Progressive disc height increase continuing after the procedure. At 14-month scan — further restoration.
X-ray: second MIBRAR® procedure L5/S1 — repeat implantation, sagittal view
L5/S1 — second procedure (20.04.2017): Repeat CGF and Lipogems® implantation to consolidate results and further increase disc height.
X-ray: L4/L5 frontal view — interdisc space increase after MIBRAR®
L4/L5 — frontal view: Probe insertion before implantation. Right — after transplantation: interdisc space increase and disc shape restoration.
X-ray: L4/L5 follow-up — disc height restoration, progressive regeneration
L4/L5 — follow-up: Progressive disc shape restoration at 4 and 14 months. Height reduction stopped and reverse process initiated.
X-ray: L4/L5 sagittal — L4 ventrolisthesis before and resolution after MIBRAR®
L4/L5 — sagittal view, ventrolisthesis resolution: Before surgery — disc height reduction and L4 ventral displacement. After — height increase, partial then full vertebral repositioning to anatomically correct position.
X-ray: final follow-up 3 months after second procedure — full reconstruction L4/L5, L5/S1
Final follow-up (14.07.2017): Complete restoration of L4/L5 and L5/S1 disc height and shape. Full return of L4 vertebra to anatomically correct position — no signs of ventrolisthesis.
X-ray: before surgery and 3-month comparison — sagittal and frontal views
Before and after comparison (sagittal + frontal): Full reconstruction of both segments — disc height restoration, L4 vertebral repositioning, sagittal balance normalization. Result of ongoing post-operative regeneration.

Tedavi Sonuçları

After 1st procedure
Hemen sonra the first intervention, radiating pain to the left leg disappeared. Numbness symptoms ceased within 3 days. Lumbar pain significantly decreased within a week. Complaints reduced by 80%.
After 10 weeks
Follow-up X-ray confirmed L4/L5 and L5/S1 disc height increase. Beginning of post-operative regeneration.
After 14 months
X-ray before second procedure: further disc height increase. L4 vertebral ventralization — no significant changes. Decision made for repeat procedure for full repositioning.
After 2nd procedure
One month after the second procedure — complete absence of complaints. For the first time in 8 years, the patient is pain-free.
Follow-up 14.07.2017
Final X-ray (3 months after 2nd procedure): full reconstruction of both segments — disc height and shape restoration, full L4 repositioning, sagittal balance normalization.
Uzun vadeli
Symptoms did not recur. The patient has no limitations, actively participates in sports. Spinal fusion was not required.

Diğer Klinik Vakalar

Bel omurgası
Lumbar Stenosis After Nucleotomy
Female, 43 years. L4/L5, L5/S1 disc reconstruction in 18 months.
Bel omurgası
Scoliosis + Spondylolisthesis + 14 mm Herniation
Female, 54 years. Scoliosis and paraparesis resolved in 2 weeks.
Göğüs omurgası
Fracture Th8–Th9 + Stenosis + Paraparesis
Male, 50 years. Symptom resolution within 1 week.
Diz eklemi
Meniscus Tear — Regeneration in 4 Weeks
Male, 56 years. Full recovery without arthroscopy.

Benzer bir durumunuz mu var?

MR görüntülerinizi gönderin — Prof. Babayan sizin durumunuzda MIBRAR® tedavisi olasılığını kişisel olarak değerlendirecektir. Danışmanlık ücretsizdir.

MR Gönder
+49 160 5736643