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Öğe CORRELATION BETWEEN SPINOPELVIC PARAMETERS AND THE DEVELOPMENT OF LUMBAR DISC HERNIATION(2019) Tuncer, Cengiz; Polat, Ömer; Er, UygurObjective: The present study aimed to identify the correlation between spinopelvic parameters and the development of lumbar disc herniation,which is a condition usually surgically treated.Materials and Methods: A total of 147 consecutive patients with low back pain were divided into two groups according to treatment withmicrodiscectomy or treatment with some medications. In all patients, pelvic incidence (PI), lumbar lordosis (LL), sacral slope (SS), and pelvic tilt(PT) angles were measured on standing profile roentgenograms of the lumbar spine and pelvis. Statistical differences were investigated betweenthe two groups.Results: The PI, LL, and SS values were significantly different between the two groups. However, the difference in terms of PT was not significant.Conclusion: Some spinopelvic parameters, such as PI, LL, SS, and PT, may be considered as predictive factors in the development of degenerativespinal diseases, and the restoration of sagittal balance may provide better results when these factors are considered.Öğe The Correlatıon Of The Growth Hormone And Severıty Of The Kyphosıs In The Patıents Wıth Schuermann Kyphosıs(2015) Karagüven, Doğaç; Benli, İsmet Teoman; Ün, Ahmet; Kurtuluş, Burhan; Er, UygurGeçmiş bilgiler: Scheuermann kifozu adölesanda görülen en sık görülen yapısal kifozdur. Etiyolojisi hali hazırda bilinmemektedir. Histolojik çalışmalar, anormal son plak kartilaj oluşumu, düzensiz ossifikasyon (Shmorl nodülleri), anormal kollajen / proteoglikan oranlarıyla giden çeşitli oranlarda kollajen agregasyonu göstermektedir. Büyüme hormonunun aşırı salınması, Scheuermann kifozunun etiyopatogenezinde rol oynadığı düşünülmüştür. Hastaların yaşlarına uygun normal persentillerden yüksek kilo ve boylarda olması bu düşünceyi desteklemektedir. Ancak, hiç bir çalışmada kesin olarak büyüme hormonu ile hastalık arasındaki ilişki gösterilememiştir.Amaç: Bu çalışmanın amacı, büyüme hormonunun, Scheuermann kifozu etiyolojisinde rol oynayıp oynamadığının ve hormon düzeyleri ile kifotik deformitenin şiddeti arasında korelasyon olup olmadığının araştırılmasıdır.Hastalar ve Metot: Ortalama yaşları 14.4 3.2, torakal kifozu 60 üzeri ve en az 3 komşu omurda 5'den fazla lokal kifozu olan 16 kız ve 15 erkek toplam 31 hasta bu çalışmaya dahil edilmiştir. Kifotik deformiteye sahip hastalar 60 - 70 (12 hasta), 71 - 80 (10 hasta) 81 ve üzeri (9 hasta) olmak üzere 3 gruba ayrılmıştır. Tüm hastaların direk PA ve lateral grafileri ile MR'ları çekilmiştir. Hastalara konservatif veya cerrahi bir tedaviye başlamadan önce sabah büyüme hormon düzeylerine bakılmıştır.Sonuçlar: Tüm hastalar dahil edildiğinde ortalama global kifoz açısının 75.23 9.65 olduğu belirlenmiştir. 60 - 70 (12 hasta) kifoza sahip hastalarda bu açının ortalama 65.92 3.58, 71 - 80 (10 hasta) kifoza sahip hastalarda ortalama 75.30 2.63 ve torakal kifozu 81 üzeri olan hastalarda (9 hasta) ortalama 87.56 4.79 olduğu saptanmıştır. Bu çalışmada yer alan 31 hastanın 28 (% 90,3)'inde büyüme hormon düzeyleri 5-16 yaş için normal sayılan erkekler için 0-11 ng/ml ve kızlar için 0-17 ng/ml aralıklarında olduğu belirlenmiştir. Sadece 3 erkek hastada (% 9.7) büyüme hormon düzeyi 11 ng/ml üzerinde bulunmuştur. Tüm hastaların büyüme hormon düzeyleri 8 ng/ml üzerinde olup hastaların % 67.7'sinde ise bu düzey 10 ng/ml üzerinde olduğu saptanmıştır. Tüm hastalar dahil edildiğinde büyüme hormon düzeyleri ortalama 10.46 1.48 ng/ml olduğu belirlenmiştir. Sonuç: Hastaların kifotik deformitelerine göre yapılan gruplardaki ortalama büyüme hormon düzeylerinin istatistikî olarak benzer olduğu görülmüştür (p 0,05). Başka bir deyişle Scheuerman kifozundaki sagittal deformitenin şiddeti ile büyüme hormon düzeyleri arasında bir korelasyon bulunamamıştırÖğe The effect of flurbiprofen on the development of anencephaly in early stage chicken embryos(Informa Healthcare, 2015) Özeren, Ersin; Er, Uygur; Güvenç, Yahya; Demirci, Adnan; Arıkök, Ata Türker; Şenveli, Engin; Ergün, Rüçan BehzatObjective. The study investigated the effect of flu rbiprofen on the development of anencephaly in early stage chicken embryos. Material and methods. We looked at four groups with a total of 36 embryos. There was a control group, a normal saline group, a normal-dose group and a high-dose group with ten, ten, eight and eight eggs with embryo respectively. Results. Two embryos in the control group, studied with light microscopy at 48 h, were consistent with 28-29 hours' incubation in the Hamburger-Hamilton System. They had open neural tubes. The other embryos in this group were considered normal. One embryo in the normal saline group was on the occlusion stage at 48 h. One embryo showed an open neural tube. They were compatible with 28-29 hours' incubation in the Hamburger-Hamilton system. The remaining eight embryos showed normal development. In the normal dose group, one embryo showed underdevelopment of the embryonic disc and the embryo was dead. In four embryos, the neural tubes were open. One cranial malformation was found that was complicated with anencephaly in one embryo. In two embryos the neural tubes were closed, as they showed normal development, and they reached their expected stages according to the Hamburger-Hamilton classification. There was no malformation or growth retardation. Four experimental embryos were anencephalic in the high dose group, and three embryos had open neural tubes. One embryo exhibited both anencephaly and a neural tube closure defect. None of the embryos in this group showed normal development. Conclusions. Even the usual therapeutic doses of flurbiprofen increased the risk of neural tube defect. Flurbiprofen was found to significantly increase the risk of anencephaly. The provision of improved technical materials and studies with larger sample sizes will reveal the stage of morphological disruption during the development of embryos.Öğe THE EFFECT OF PREOPERATIVE CERVICAL SAGITTAL ALIGNMENT ON POSTOPERATIVE SURGICAL RESULTS IN PATIENTS TREATED BY ANTERIOR CERVICAL DISCECTOMY AND FUSION(2019) Subaşı, Canan; Tuncer, Cengiz; Er, UygurObjective: Cervical degenerative disc diseases arise in some degenerative settings. These degenerative cervical changes may be a consequenceof cervical sagittal malalignment. The aim of this study is to assess preoperative profile and postoperative changes in cervical sagittal profiles;and correlation between these changes and surgical outcomes in patients undergoing anterior cervical discectomy and fusion.Materials and Methods: Eighty consecutive men and women who underwent anterior cervical discectomy and fusion (ACDF) were enrolled inthe study. Cervical alignment was classified into 4 types-lordotic, flat, sigmoid, and kyphotic. Lordosis angle was measured by the Cobb method.Segmental angle at the level of discectomy was measured. Preoperative, early postoperative, and the 1st and 3rd month visual analog scale resultswere recorded. Improvement of cervical sagittal alignment and visual analogue scale (VAS) changes were compared statistically.Results: The median preoperative VAS score was 7. This score decreased to 1 as a median immediately after operation. This change was statisticallysignificant. Sagittal alignment changes in early postoperative period were not statistically significant despite the observation of improvement insome patients. However, after 1st and 3rd months, results showed significant improvements.Conclusion: ACDF is an effective treatment of cervical degenerative disc diseases (CDDD). Decompression is still the main issue of the degenerativecervical diseases. Sagittal alignment may be restored by using lordotic cages. Patients with F sagittal shape may tend to develop CDDD more thanN sagittal profile. There is a correlation between clinical improvement and radiologic improvement.Öğe Effect of topical rifamycin application on epidural fibrosis in rats(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Dinç, Cem; Tuncer, Cengiz; Türkoğlu, Mehmet Erhan; Tokmak, Mehmet; Ocak, Pınar; Er, UygurObjectives: This study aims to investigate the effects of topical rifamycin SV application on epidural fibrosis formation in a rat model. Materials and methods: Between March 2015 and April 2015, a total of 20 Wistar rats were equally and randomly divided into laminectomy only group (control group) and laminectomy and rifamycin SV group (treatment group). Laminectomy was performed between L3-L5 in all rats. Surgical field was irrigated with 1 mL rifamycin SV (1 mL). After four weeks, vertebral columns of the rats were removed en bloc between the L1 and L5 levels, and epidural fibrosis and arachnoid involvement were histopathologically evaluated and graded. Results: Grade 3 epidural fibrosis formation ratio was lower in the treatment group (40%) compared to the control group (80%). However, there was no statistically significant difference between the treatment and control groups in terms of epidural fibrosis (p=0.164) and arachnoid involvement (p=0.303). Conclusion: Intraoperative rifamycin irrigation tends to reduce epidural fibrosis formation risk, although not statistically significant.Öğe Effects Of Etofenamate And Methylprednısolone On Spınal Cord Injury(2015) Kazancı, Burak; Er, Uygur; Sabuncuoğlu, Hakan; Güçlü, BülentBu çalışma omurilik hasarını izleyen ikincil olaylar üzerine etofenamate' ın etkisini değerlendirmek ve bu etkiyi metilprednizolon etkisi ile karşılaştırmak amacıyla yapılmıştır. Toplam 31 erkek Wistar-Albino sıçan kullanılmıştır. 50g-cm etkili ağırlık düşürme modeli deneysel omurilik hasarı oluşturmak için kullanılmıştır. Sıçanlar üç çalışma koluna randomize olarak ayrılmışlardır (saline, etofenamate 20 mg/kg, metilprednizolon 30 mg/kg). Hasarın 6.saatinde anestezi altında elektrofizyolojik değerlendirme yapılmış ve sonra histopatolojik inceleme için sıçanlar feda edilmiştir. Hematoksilin-eozin boyaması ile ışık mikroskopu altında değerlendirilmiştir. Etofenamate, metilprednizolon ile karşılaştırıldığında histopatolojik olarak daha faydalı bulunmuştur, fakat bu durum elektrofizyolojik olarak doğrulanamamıştır. Etofenamate omurilik hasarının tedavisinde ümit verici olabilirÖğe Experıence On Surgıcal Treatment Of Sıngle-Level Thoracıc Dısc Hernıatıons Vıa Costotransversectomy Approach(2014) Er, Uygur; Şimşek, SerkanAmaç: Kostotransversektomi yaklaşımı ile tedavi edilen tek seviyeli torakal disk hernisi hastalarının sonuçlarını sunmak ve yaklaşımın avantaj ve dezavantajlarını tartışmak. Hastalar ve Yöntem: 2004 ve 2011 yılları arasında kostotransversektomi yöntemi ile ameliyat edilen 21 hastanın disk seviyeleri, geliş yakınmaları, izlem süresinde bulgu ve belirtilerindeki düzelmeler ve komplikasyon oranları sunuldu.Sonuçlar: Genel komplikasyon oranı komplike olay bazında % 38, hasta topluluğu bazında ise %19 olarak hesaplandı. En sık başvuru yakınması ağrı olup aksiyal, bölgesel ya da radiküler olarak görülebilmektedir. En yüksek iyileşme oranı ağrı yakınmasında izlenmiştir. Bu yaklaşımda ameliyat süresi kısa, kan kaybı azdır.Son Çıkarım: Kostotransversektomi iyi bir posterolateral görüş sağlayan, güvenli, kolay, az invaziv bir yaklaşım olarak torakal disk hernilerinin cerrahi tedavisinde ilk sıralarda akılda bulundurulması gereken bir yöntemdirÖğe Laminektomi Ve Posterior Füzyonoperasyonlarının Sonuçları İle Servikal Sagital Dizilim İlişkisi(2017) Şimşek, Serkan; Er, Uygur; Yiğitkanlı, KazımServikal sagittal denge ve dizilim radyolojik ve klinik sonuçlarda oynadığı rol ile son zamanlarda dikkat çekmektedir. Bu çalışmanın amacı bazı servikal patolojiler nedeniyle laminektomi ve enstrümanlı füzyon yapılan hastalarda servikal sagittal denge değişimlerini ve bunun sonuçlara etkisini araştırmaktır. Retrospektif olarak düzenlenmiş bu çalışmada çeşitli derece ve seviyelerde kanal darlığı olan 44 erkek ve 6 kadın hasta yer almışlardır. Ameliyat öncesi ve sonrası mJOA derecesi ortalama değerleri sırasıyla 7.76 ve 12.96 'dur. Servikal lordoz açısı (CLA) değişimi istatistiksel olarak anlamlı olmakla beraber C2-7SVA değişimi istatistiksel olarak anlamlı değildir. Servikal sagittal denge ve dizilim posterior dekompresyon ve enstrümanlı füzyon yapılması planlanan hastalarda cerrahi sonuçlar değerlendirilirken mutlaka göz önüne alınmalıdır.Öğe LAMINOPLASTY FOR THE SURGICAL TREATMENT OF VARIOUS SPINAL CANAL PATHOLOGIES(Galenos Publishing House, 2021) Oktay, Kadir; Güzel, Ebru; Özsoy, Kerem Mazhar; Çetinalp, Nuri Eralp; Er, Uygur; Güzel, AslanObjective: It was aimed to evaluate the patients who underwent laminoplasty for the various pathologies that were located in the spinal canal. Materials and Methods: The records of the patients who underwent osteoplastic laminoplasty for various pathologies between 2014 and 2019 were analyzed retrospectively. Patient data including age, gender, preoperative and postoperative neurological conditions, type and radiographic localization of their pathologies, preoperative and postoperative deformities, involved segments, hospitalization periods and postoperative complications were gathered. Results: Sixty-two patients were included in the study. The mean age of the patients was 44.3 years (9-80 years). Fifty-two patients had tumoral and 10 patients had non-tumoral pathologies. Grade 3 and 4 patients were predominant in the preoperative period, while grade 1 and 2 patients were predominant in the postoperative period according to Modified McCormick Scale classification of the patients. Twenty-three patients had preoperative deformity. A total of 138 laminae were reconstructed. One patient had cerebrospinal fluid leak in the long-term period and 1 patient had quadriplegia and respiratory deficiency in the postoperative period. In only 1 patient, a new-onset deformity developed and in 1 patient, progression of previous deformity was seen. However, the deformities of these patients did not require corrective surgery. Conclusion: Laminoplasty technique has recently gained popularity and begun to replace traditional laminectomy technique. Laminoplasty is a preferred technique with the low complication rates and high patient-comfort in the postoperative period. ©Copyright 2021 by the Turkish Spine Society / The Journal of Turkish Spinal Surgery published by Galenos Publishing House.Öğe Length Of The Trajectory Of Anterıor Odontoıd Screw In Adult Turkısh Populatıon: Morphometrıc Study(2015) Er, Uygur; Benli, İsmet TeomanC1, C2 düzeyinde yapılacak sabitlemede aksiyal rotasyonu korumak için anterior odontoid vidası kullanılmaktadır. Bu morfometrik çalışma erişkin Türk toplumunda uygun anterior odontoid vidası boyunu belirlemektir. Vida yolu ölçümleri T1-A midsagittal MRG üzerinde yapılmıştır. Vida yolunun ortalama uzunluğu 3.520.81 cm. dir. Sıklıkla kullanılan 35 mm. vidalar toplumun yarısı ıçın uygun olduğu belirlenmiştirÖğe Lumbar Spınal Aspergıllus Abscess In An Immunocompetent Patıent(2018) Güzel, Ebru; Güzel, Aslan; Şimşek, Serkan; Er, UygurOnly a few species of Aspergillus cause infections in humans. But, these infections lead highly mortal abscesses by located in the central nervous system and spine. It is accentuated frequently in the literature that these infections were seen in immunocompromised patients. The aim of this case report is that spinal involvement of Aspergillus should be kept in mind even in immunocompetent patients initially considered as tuberculosis by radiology. Mortality rate may be reduced by surgical decompression and rigorous antifungal therapy.Öğe Melanotic schwannoma of the L5 root(Sage Publications Inc, 2016) Güzel, Ebru; Er, Uygur; Güzel, Aslan; Toktaş, Zafer; Yapıcıer, ÖzlemMelanotic neoplasm of the central nervous system is rare and the majority of them are metastatic. Melanotic schwannoma (MS) is an unusual variant of nerve sheath neoplasm accounting for less than 1% of primary nerve sheath tumors. A case involving a 36-year-old man with MS at the L5 root is presented. Surgery, differential diagnosis, radiology, histology, and treatment of this rare entity are discussed.Öğe Servikal Longitudinal Ligaman Ossifikasyonu İçin Açık Kapı Laminoplastinin Geç Sonuçları(2017) Akyol, Çetin; Er, Uygur; Şimşek, Serkan; Bavbek, MuradGiriş: İleri dönük olarak planlanmış bu çalışmada, açık kapı laminoplasti (ODL) hasta dizisi sunularak, bu yaklaşımın etkinliği ve ameliyat öncesi kanal alanı ile hastaların belirti ve bulguları arasında ilişki olup olmadığının araştırılması amaçlanmıştır. Hastalar ve yöntem: En az 36 ay takip edilmiş 47 hastalık bir topluluk çalışmaya alınmıştır. Tüm hastalara standart ODL yapılmıştır ODL. Ameliyat öncesi ve ameliyat sonrası çeşitli zamanlarda klinik ve radyolojik sonuçlar istatistiksel olarak karşılaştırılmışlardır. Hastaların iyileşme oranları hesaplanmıştır. Sonuçlar: Hastaların iyileşme oranları Friedman testi ile istatistiksel olarak anlamlı bulundu. Ameliyat öncesi kanal alanı ile klinik arasında ilişki yoktu. Belirti ve bulgu süresi ile iyileşme oranı arasında ters ilişki olması dikkate değer bir durumdur. Çıkarım: ODL, OPLL nedeni ile gelişen servikal dar kanalda belirti ve bulguların giderilmesi için etkin ve güvenli bir yaklaşımdırÖğe Spınal Surgery Complıcated Wıth Some Congenıtal And Chıldhood Neural Dıseases(2017) Özışık, Pınar Akdemir; Özer, Esra; Er, UygurObjective: This study was a retrospective clinical research based on challenging cases with clinical and radiological data analysis, and the review of literature. The aim of this study was to determine the factors affecting spinal deformity treatment in patients with diseases of the central nervous system following neurosurgical management. Material and Methods: Three sample cases presented and the relevant literature were interpreted by the lights of these analyses. Patients are consisted of 20 and 44 years old females and 9 years old boy with childhood neural diseases. These accompanying diseases were detected during evaluation for spinal surgery by neurologic examination and imaging modalities.Results: All patients have been doing neurologically well with almost no deficits and manageable pain problems. A 44-year-old woman who had CSF diversion operation previously, was resolved her arachnoiditis by extending the cervical stenosis operation. Neurofibromas that complicated kyphosis operation of a 9-year-old boy were removed. And tethered cord of a 20-year-old girl was untethered during scoliosis operation. All patient's neurological status is well after operations and follow-ups.Conclusions: Surgical treatment of patients with spinal diseases may become a quite challenging case when they have congenital anomalies or CNS related problems. Staging surgical approach should be kept in mind for these kinds of patients. Besides, growing of spine and spinal cord at different rates shouldn't be forgotten for children. The whole spinal axis must be kept under lifetime control by some regular intervals for spine patients with additional congenital or CNS anomalies.Öğe An unexpected challenging airway: Urticaria factitia caused difficult mask ventilation and tracheal intubation(Elsevier Science Inc, 2019) Özlü, Onur; Yorulmaz, İlknur Suidiye; Esbah, Ali Ümit; Er, Uygur…Öğe USE OF BETA-TRICALCIUM PHOSPHATE WITH BONE MARROW ASPIRATE AS A BONE GRAFT SUBSTITUTE IN POSTEROLATERAL LUMBAR FUSION(2019) Tuncer, Cengiz; Polat, Ömer; Er, UygurObjective: Retrospective clinical study. This study aimed to determine the bony fusion rate of posterior lumbar fusion (PLF) involving betatricalciumphosphate (ß-TCP) and bone marrow aspirate (BMA). Bone fusion remains the main component of primary surgical approach for severalspinal disorders. Spine surgeons face the need to make crucial decisions regarding bone graft selection in each case.Materials and Methods: The study included 33 patients (21 female and 12 male patients) who underwent posterior lumbar pedicle screw fixationand fusion using ß-TCP as a bone substitute. The mean patient age was 58.35 (range=35-81) years.Results: The mean follow-up duration was 23.45 months. Solid bony fusion at the lateral side of the lumbar region between transverse processeswas noted on radiography in 24 patients (72.7%), bony bridging between adjacent transverse processes in 5 patients (15.2%), and no new boneformation in the remaining 4 patients (12.1%).Conclusion: The bony fusion rate of PLF involving ß-TCP and BMA was relatively high at 72.7%. ß-TCP is an effective and appropriate material forPLF in the lumbar area when used with BMA, and approximately 10 mL of ß-TCP per vertebral segment is sufficient.
