Objective: The purpose of this study was to evaluate clinical and radiological findings related to the treatment of the patients with cervical spondylotic myelopathy (CSMP) in our medical center who underwent posterior cervical laminectomy and posterolateral fusion surgery with lateral mass screw fixation (LMSF).Materials and Methods: In this study, the postoperative clinical and radiological results of 30 patients who underwent posterior laminectomy and posterolateral fusion surgery by a single spinal surgeon with the diagnosis of cervical spondylosis in our medical center between 2015 and 2019 were retrospectively evaluated.Results: In total, 30 patients [23 males (76.7%) and 7 females (23.3%)] were included in the study, and the follow-up period was 6 to 44 months with an average of 21.2 months. In total, 91 laminectomies were performed on the cervical vertebrae of our patients. The mean diameter of the spinal canal in the narrowest place was 5.80 mm (9.6, 2.5) in the preoperative period, and 11.16 mm (13.6-9.4) in the postoperative period. In the postoperative period, an average of 1.35 mm (0.4-3.1) spinal cord shift was observed. The mean modified Japanese Orthopedic Association scores of all patients increased postoperatively to 15.2 (8-18) from the preoperative values of 12 (6-16). While mean preoperative Cobb angle in Group A was - 23.5º (-45º/-10º), mean postoperative Cobb angle was -9.8º (-34º/+15º). While mean preoperative Cobb angle in Group B was +13.8º (+3º/+33º), mean postoperative Cobb angle was +13.3º (+32º/-5º).Conclusion: In the treatment of patients with CSMP, adequate spinal canal decompression is created with posterior laminectomy and the LMSF technique, and these provide sufficient neurological recovery and stability. Posterolateral stabilization can preserve cervical alignment in patients with lordotic spine alignment and prevent progressive kyphosis after laminectomy; however, if anterior osteophytosis is present in patients with a preoperative loss of lordosis or kyphotic alignment, this technique may not be suitable for ideal lordotic alignment.
|
Objective: Lumbar disc herniation (LDH) is a socio-economic burden. The physiopathology of the disease is not clarified completely. This study aimed to investigate the oxidation-reduction balance in LDH via serum thiol-disulfide and ischemia-modified albumin (IMA) levels. Materials and Methods: This prospective case-control study included 30 patients with LDH and a control group with 30 healthy volunteers. Blood samples were analyzed for total thiol (-SH+ -S-S-), native thiol (-SH), and IMA levels. Disulfide levels and native thiol/total thiol ratio were calculated. The results of the two groups were compared. Results: Native and total thiol levels were significantly higher in the LDH group than in the control group (p=0.007 and p=0.008, respectively). IMA levels were significantly higher in the LDH group than in the control group (p=0.000). The receiver operating characteristic curve demonstrated that the IMA value of 1.41 could predict the LDH with 80% sensitivity and 80% specificity (area under curve=0.888, confidence interval: 0.802- 0.974). Conclusion: LDH influences the thiol-disulfide balance, and increased IMA levels can predict LDH.
|
Objective: Tea contains antioxidant compounds from the polyphenol group known as catechins. The most abundant of catechins is Epigallocatechin3-gallate (EGCG). Epidemiological studies show that tea has a protective effect against cancer, neuronal damage after transient global ischemia and cardiovascular diseases. This study aimed to investigate a possible neuroprotective effect of EGCG in a rat spinal cord injury (SCI) model. Materials and Methods: The study was performed with 35 Albino-Wistar rats. Rats were divided into five groups: daily consumption group (intraperitoneal given ECGC 1.7 mg/kg/day), treatment groups (intraperitoneal given ECGC 5 mg/kg/day and 10 mg/kg/day), saline group and control group for 14 days prior to trauma. All groups, other than the control group, injured with a pressure of 35 g/cm2 and 1-minute compression. These operations were applied to the spinal cord at level T9-T10. In all groups, nerve samples were taken after 28 days and examined biochemically and histopathologically. Results: In our study, daily consumption ECGC group, 5 mg/kg ECGC group and 10 mg/kg ECGC group statistically significant lower level of lipid peroxidation. Especially daily consumption ECGC group and 5 mg/kg ECGC group were positively decreased histological degeneration and oedema. Histological evaluation, white-grey matter sparing, glial scar formation, protoplasmic astrocytes’ number, cavity size, also had better results in these groups. Conclusion: In this study, it has been shown that catechin group antioxidant substances in tea have a protective effect in neuronal damage such as SCI.
|
Meningiomas are usually located in the central nervous system and arise from the membranes surrounding the brain and spinal cord. Rarely, theymay also be located in the skin and in this case they are known as cutaneous meningiomas. Herein, we report a case of cutaneous meningiomaswithin the dermal sinus tracts, located in the midline of the lumbosacral junction, the diagnosis of which was confirmed by histopathologicalexamination.
|
Odontoid çıkıntı kraniyoservikal bileşkenin geniş hareket becerisi açısından önemli bir parçasıdır. Böylesi geniş hareket aralığı ilebirlikte stabilitenin idamesi de ayrı bir özellik taşımaktadır. Bu yüzden odontoid kırıkları servikal kırıklar içinde önemli bir yere sahiptir.Çoğunluğu yüksek enerjili travmalarla oluşur ve sıklıkla zorlayıcı fleksiyon ve/veya ekstansiyon hareketleri sonucu oluşmaktadır. Heryaş grubunu etkiler; gençlerden farklı olarak yaşlı hasta grubunda düşük enerjili travmalar sonucunda da görülmektedir. Ölüm veciddi sakatlıklara neden olması nedeni ile odontoid kırıklarının tanı ve tedavisi önem arz etmektedir. Tanı ve tedavi planlamasındasıklıkla kullanılan Anderson ve D’Alanso sınıflaması kullanılır. Kırık tipine göre konservatif ve cerrahi tedavi seçenekleri bulunmaktadır.
|
Objectives: This study aims to examine the effect of surgical timing on the sphincter function and improvement of motor function in patientswith cauda equine syndrome (CES) due to lumbar disc herniation (LDH).Patients and methods: Between January 2005 and December 2013, a total of 33 patients (18 males, 15 females; mean age 48.6±2.2 years, range,24 to 73 years) who underwent lumbar spinal surgery and were diagnosed with CES due to LDH were retrospectively analyzed. Data includingdemographics, muscle weakness, sensory deficit, sphincter control, LDH level, time from the initiation of symptoms to admission, and time tosurgery were documented. The latest muscle weakness, sensory deficits, and sphincter control were also recorded. The patients were divided intotwo groups according to the rate of muscle strength improvement and data including age, sex, and operation time were compared.Results: The weakness remained unchanged in 11 (33.3%), improved in 13 (39.4%), and returned to normal in nine (27.3%) patients. Sphinctercontrol resolved in five patients. Sensory loss resolved in two patients. While admission duration was shorter in the group with improvedmuscle strength (p=0.02), there was no significant difference in the time to surgery (p=0.63). Logistic regression analyses revealed that onlythe admission within 0 to 24 hours was significant for the muscle strength improvement (regression coeeficient [B]=2.83, standard error[SE]=0.86, p=0.006).Conclusion: A significant improvement in the motor strength can be achieved in patients with CES who are operated within 24 hours. Onthe other hand, patients with CES should be received surgery immediately when first seen, regardless of the time, since the muscle strengthis slightly improved.
|
