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Öğe Bilgisayarlı Tomografi Anjiyografi ile Anevrizma Ameliyatı Yapalım mı?(2019) Seçer, Mehmet; Sekmen, Haydar; Polat, ÖmerAnevrizma rüptürüne bağlı; subaraknoid kanamanın (SAK) ileri tedavi yöntemlerine rağmen halen yüksek mortalite ve morbidite oranınasahiptir. Nöro-görüntülemenin; anevrizmal morfolojinin tedaviyi yönlendirmek için doğru bir şekilde karakterize edilmesi önemlidir.Serebral anevrizmalı hastaların değerlendirilmesinde ve tedavi edilmesinde görüntüleme yöntemleri kritik öneme sahiptir. Bilgisayarlıtomografi anjiyografi (BTA) manyetik rezonans anjiyografi (MRA) ve dijital subtraksiyon anjiyografi (DSA) üç ana görüntüleme yöntemiserebral anevrizmaların nöro-görüntülenmesi için kullanılmaktadır. Her nöro-görüntüleme tekniği kendine özgü güçlü, zayıf yönleribulunmakla birlikte güncel gelişmelere açıktır. BTA; anevrizma lokalizasyonun ve morfolojisinin belirlenmesinde daha az invazif, dahahızlı, daha kolay, daha ucuz bir tanı yöntemidir. Anevrizmalı olgunun klinik ve radyolojik görüntülerinin örtüşmesi, anevrizmanın çevrevasküler yapılarla ilişkisinde çelişki olmaması durumunda BTA anevrizma cerrahisinde ilk tanı modalitesi olabilir.Öğe Cerrahi Tedavi Planlanan Lomber Disk Hernisi Hastalarında Geleneksel ve Tamamlayıcı Tıp Tekniklerinin Kullanımı: Anket Çalışması(2023) Kılıç, Güven; Polat, Ömer; Esbah, Ali ÜmitAmaç: Lomber disk hastalığı ortaya çıkardığı kronik ve tekrarlayıcı bel ağrısı nedeniyle hastaların yaşam kalitelerini ve psikolojik durumlarını etkilemektedir. Ayrıca ciddi iş gücü ile ekonomik kayba neden olabilen bir hastalıktır. Ağrı nedeniyle son yıllarda hastalar geleneksel ve tamamlayıcı tıp tekniklerine yönelebilmektedir. Bu çalışmanın amacı lomber disk hernisi nedeni ile cerrahi uygulanacak hastalarda, geleneksel ve tamamlayıcı tıp uygulamaları (GETAT) ve non-farmakolojik yöntemler kullanma durumunun ve kullanılan yöntemlerin incelenmesidir. Gereç ve Yöntemler: Lomber disk hernisi nedeni ile cerrahi tedavi endikasyonu konulmuş 36 hasta çalışmaya dahil edildi. Hastalar nörolojik muayene, Vizüel Analog Skalası, Karnofsky performans ölçeği ile değerlendirildi. Hastaların demografik ve klinik özellikleri ile GETAT ve non-farmakolojik yöntemler kullanma durumuna yönelik sorular yüz yüze görüşme sırasında soruldu. Bulgular: Cerrahi endikasyon konulup çalışmaya katılan hastaların 18’i (%50) erkek ve 18’i (%50) kadın, yaş ortalaması 47,69±8,05 yıl idi. Herhangi bir GETAT yöntemi hastaların %55,6’sında tanı konulduğunda uygulatılmıştı. En sık uygulatılan GETAT yöntemi hacamattı. Fayda görmediğini bildiren hasta sayısı 27 (%75), daha kötüleştiğini bildiren hasta sayısı ise iki (%5,6) idi. Hastaların 26’sı (%72,2) bu yöntemlerin kullanılmasını önermemekteydi. GETAT uygulayan kişilerden sadece 4’ünün (%11,1) doktor olduğu öğrenildi. Sonuç: Türk toplumunda da giderek kullanım sıklığı artan GETAT yöntemlerinin halk arasında doğru şekilde anlatılarak, bu konuda doğru bilgilenmenin sağlanmasına, sağlıkçılar tarafından uygulamaların yapılması konusunda önlemler alınmasına ihtiyaç vardır.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 Deneysel Omurilik Yaralanmasında İsotretinoinin Nörorejenerasyon Üzerine Klinik ve Histopatolojik Etkileri(Düzce Üniversitesi, 2024) Şensoy, Doğan; Polat, Ömer; Kılıç, Güven; Yakupoğlu, Muammer; Karacor, KayihanAmaç: Omurilik yaralanması önemli bir sorundur ve henüz tam olarak etkili bir tedavi geliştirilememiştir. İsotretinoin, anti-inflamatuar etkisiyle bilinen bir retinoiddir. Bu çalışmanın amacı, yaralanma sonrası sinir dokusu üzerinde isotretinoinin olumlu bir etkisinin olup olmadığını değerlendirmektir.Gereç ve Yöntemler: Toplam 36 sıçan kontrol, sham ve travma ile 14 günlük 7,5 mg/kg/gün, 28 günlük 7,5 mg/kg/gün, 14 günlük 15 mg/kg/gün ve 28 günlük 15 mg/kg/gün isotretinoin grupları olmak üzere 6 gruba ayrıldı. Sıçanlara laminektomi yapıldı ve omurilik yaralanması klip kompresyon tekniği kullanılarak oluşturuldu. Nörolojik muayene 1, 7, 14 ve 28. günlerde yapıldı. Tedavi süresinden sonra tüm sıçanlar öldürüldü ve histopatolojik değerlendirme için omurilik örnekleri toplandı.Bulgular: 7,5 mg/kg/gün (p=0,048) ve 15 mg/kg/gün (pÖğe Evaluating of the Outcomes of Median Nerve Decompression with a Mini Incision Proximal to the Distal Wrist Crease(2019) Polat, ÖmerAIM: To evaluate the feasibility of the mini-open incision method in patients who underwent median nerve decompression in thecarpal tunnel with a mini incision made proximal to the distal wrist crease.MATERIAL and METHODS: A total of 80 patients (84 hands) operated by a single surgeon with a mini incision were included. Thepatients were evaluated postoperatively for the presence of pillar pain, pain on the incision scar, and scar sensitivity in additionto preoperative findings. The Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH) questionnaire was used for clinicalscoring. To evaluate the effectiveness of the method, the findings were recorded at and compared between at 12 and 24 monthsfollow-ups.RESULTS: No complications were observed at the wound site in the early postoperative period. Ten patients reported numbness,5 experienced weakness, and 4 revealed positive Tinel’s sign. Keloid formation without pain and scar sensitivity was detected in 2patients at 6 months. No patient reported night pain, pain on pillar or incision scar, scar sensitivity, recent sensory loss, and diseaserecurrence. Numbness was present in 7 patients at 12 months and in 3 at 24 months; 3 and 2 patients reported weakness at 12 and24 months, respectively. The mean Quick DASH score was 72.7 preoperatively, 10.2 at 12 months, and 9.1 at 24 months.CONCLUSION: The median nerve decompression in the carpal tunnel may be performed with a mini incision made proximal to thedistal wrist crease is effective and safe method, and provides less complications and higher patient comfort.Öğe İnfratentoryal Arteriovenöz Malformasyonlar Daha mı çok Kanar?(2019) Polat, Ömerİnfratentoryal arteriovenöz malformasyonlar tüm intrakraniyal arteriovenöz malformasyonların %7-15’ini temsil eden konjenitalvasküler lezyonlardır. Supratentoryal arteriovenöz malformasyonlardan daha az görülmesine rağmen, daha fazla rüptür, morbiditeve mortaliteye neden olmaktadır. Arteriovenöz malformasyonun kanama riskini artıran faktörler arasında ilk kanama, arteriovenözmalformasyonun derin yerleşimli (posterior fossada yerleşmesi) olması ve derin venöz drenaj varlığı en sık rastlanan faktörler olarakgösterilmiştir. Posterior fossada yerleşmiş olan arteriovenöz malformasyonların sessiz seyir gösterdikleri, kanama dışında nörolojikbulgu oluşturmadığı için de ancak kanadıklarında teşhis edilebilir oldukları belirtilmektedir. Kanamanın neden daha sık ortaya çıktığıile ilgili yapılan çalışmalarda yaş, nöbet insidansının az olması, posterior fossada ortaya çıkan hemodinamik faktörler ve prenidalanevrizmaların infratentoryal arterivenöz malformasyonlarda daha fazla oranda ortaya çıkmasının etkili olduğu belirtilmektedir. Ancakbu konuda yapılmış çalışmaların henüz az sayıda olduğu ve yetersiz olabileceği belirtilmektedir.Öğe Investigation of Lateral Epicondylitis in Neurosurgeons(2019) Polat, Ömer; Tuncer, Cengiz; Katı, Yusuf Alper; Uckun, Ozhan Merzuk; Er, UyğurAIM: To investigate the frequency of lateral epicondylitis (LE), depending on the tasks performed by neurosurgeons, and to determinewhether it can be accepted as an occupational disease depending on its frequency.MATERIAL and METHODS: All neurosurgery specialists enrolled in the Turkish Neurosurgical Society website were prospectively included. A questionnaire form was shared, and the subsequent responses were recorded. Those who provided incomplete responseswere excluded from the study. The respondents diagnosed with LE were recorded. Exclusion criteria were investigated on complaints ofpain. They were examined by an orthopedics and traumatology specialist with application of Thomsen test and necessary maneuvers.RESULTS: The study was conducted with 216 neurosurgeons. Those with more than 30 operations per month (p=0.002), those with aspecialization duration of 10–20 years and >20 years (p=0.001), and those who specialized in spinal surgery (p=0.014) had a significantlyhigher prevalence of epicondylitis. Considering the relationship between lumbar/thoracic pedicle screw insertion and epicondylitis, theepicondylitis diagnosis rate was significantly higher in physicians inserting 20–60 screws per month than those inserting <20 screws(p=0.009).CONCLUSION: LE frequently occurs in neurosurgeons who regularly perform spinal instrumentation and appears to be an occupationaldisease. However, data obtained during the current study should be combined with findings from case-control studies of neurosurgeons.Öğe Is IL-8 level an indicator of clinical and radiological status of traumatic brain injury?(2019) Polat, Ömer; Uckun, Ozhan Merzuk; Tuncer, Cengiz; Belen, Ahmet DenizBACKGROUND: Since understanding the fact that traumatic brain injury includes an inflammatory process, the number of studiesof cytokines has increased. The objective of this study was to analyze and discuss the association of interleukin (IL)-8 level with theclinical and radiological status of patients with head trauma.METHODS: Patients who were admitted to our hospital due to head trauma were included in the study. Findings of clinical and laboratory examinations were analyzed. Data regarding patient age, gender, available clinical findings, Glasgow Coma Scale (GCS) score,trauma cause, brain tomography findings, and biochemical laboratory test results were recorded. The patients were divided into 3groups according to their GCS score: Group I: GCS ?13, Group II: GCS = 9–12, and Group III: GCS = 3–8.RESULTS: A total of 23 (76.7%) patients were male and 7 (23.3%) were female. Overall, 17 (56.7%) patients were admitted due to afall, 8 (26.7%) due to a traffic accident, and 5 (16.7%) due to assault. Each group comprised 10 patients. As the GCS score increased,the IL-8 level decreased. The mean IL-8 level was 1.2 pg/mL in Group I, 6.6 pg/mL in Group II, and 4.7 pg/mL in Group III; however,there was no statistically significant difference between the groups (p=0.147). Moreover, the IL-8 level was significantly greater in patients who demonstrated an abnormal tomography finding (p=0.023).CONCLUSION: IL-8 may be a beneficial indicator for monitoring the clinical and radiological status of traumatic brain injury.Nonetheless, studies of larger cohorts in which IL-8 levels are measured at all stages of brain injury and follow-up of long-term prognosis are warranted.Öğe Konik ve silindirik pedikül vidalarının sıyırma dirençleri ve direngenliklerinin karşılaştırmalı biyomekanik analizi(2019) Polat, Ömer; Gezici, Ali Rıza; Uçkun, Özhan Merzuk; Nacar, Osman ArıkanAmaç: Transpediküler enstrümantasyonda konik ve silindirik pedikül vidaları sık kullanılmaktadır. Vidaların mekanik performansı kemik-vida yüzeyinin biyomekanik özellikleri ve vidanın fiziksel yapısı ile ilişkilidir. Bu çalışmada, konik ve silindirik pedikül vidalarının biyomekanik açıdan farklarının olup olmadığının araştırılması amaçlandı. Yöntem: İskelet maturasyonunu tamamlamış, 400-600 kg ağırlığında 24–32 haftalık danalardan elde edilmiş taze lomber vertebralar kullanıldı. Toplam 24 vertebranın her iki pedikülüne (48 pedikül) vida yerleştirilerek biyomekanik testler uygulandı. Vidaların maksimum giriş tork değerleri analog tork metre kullanılarak kaydedildi. Rijid tespitin sağlanması için polimetilmetakrilat içeren metal kutuların içerisine gömülü vertebradaki pedikül vidaları mekanik test makinasına bağlanarak sıyırma direnci ölçüldü. Bulgular: Konik vidaların sıyırma dirençlerinin ve direngenliklerinin ilk atım ve tekrarlayan atımlarda silindirik vidalara göre yüksek olduğu, ancak aradaki farkın istatistiksel olarak anlamlı olmadığı tespit edildi (p>0.05). Maksimum giriş tork değeri ise konik vidalarda silindirik vidalara göre istatistiksel olarak anlamlı düzeyde yüksek idi (p=0.04). Vidaların 180º ve 360°geri çekimli sıyırma direnci ve direngenlik verileri arasında istatistiksel olarak anlamlı fark olmadığı tespit edildi (p>0.05). Sonuç: Konik vidaların silindirik vidalara göre daha dirençli tutunma verilerine sahip olmalarının yanı sıra, aynı delikten yapılan çoklu vida atımlarında ya da geri çekilme işlemi sonucunda vidalar arasında sıyrılma verileri açısından belirgin bir fark izlenmemiş olması, konik vidaların gelecekte daha sık kullanılacaklarını düşündürmektedir.Öğe Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery(2019) Tuncer, Cengiz; Polat, ÖmerAim: Chronic subdural hematoma is one of the most common extracerebral hemorrhages thatcauses significant morbidity with increasing human life. Associations with mild head traumaare reported in 60-80% of the literature. The aim of this study is to investigate whether localand general anesthesia performed in the operation of chronic subdural hematoma patients makea difference in terms of operative time, operation cost and total times for using the operatingroom.Material and Methods: The records of 27 patients who were operated with diagnosis ofunilateral chronic subdural hematoma between the years 2016 and 2018 in Duzce UniversityMedical Faculty Training and Research Hospital, Neurosurgery Department were reviewedretrospectively. Age, gender, ASA score, operative time, time between entry and exit to theoperating room, length of hospital stay and operating costs were recorded.Results: It was found that the operating cost and total time between entry and exit to theoperating room were shorter in patients undergoing local anesthesia, and the differencebetween patients undergoing general anesthesia was found statistically significant (both pvalues are <0.001).Conclusion: In our study, a significant difference was found between the time of entrance andexit of patients who underwent local and general anesthesia. In the general anesthesia group,the costs were significantly higher. In patients with chronic subdural hematoma, localanesthesia is a more useful method in terms of efficient use of hospital operating room andreduction of operating costs. We believe that this practice will also contribute to the nationaleconomy.Öğe POSTERIOR APPROACH IN TRAUMATIC THORACIC AND THORACOLUMBAR SPONDYLOPTOSIS(2019) Polat, Ömer; Seçer, Mehmet; Çınar, Kadir; Ulutaş, Murat; Karakoyun, OğuzObjective: Traumatic spondyloptosis a 100 % or more subluxation of a vertebral unitover another inferior unit in the sagittal or coronal plane is a very rare pathology. Inthis study, clinical findings and follow-up results of 12 patients with spondyloptosisthat occurred after a high-energy trauma were evaluated.Material and Methods: Twelve cases with the thoracic and thoracolumbar regiontraumatic spondyloptosis at two separate centres in the city of Gaziantep between2010 and 2016 were examined retrospectively. The clinical and radiological results,additional system injuries and long-term results of the patients were evaluated.Results: The mean age of the patients (9 men and 3 women) was 30.4. The causesof trauma were falling down from a height (8 cases) and a traffic accident (4 cases).Spondyloptosis was detected at the upper thoracic level in two cases (Th3-4 andTh4-5); Th9-10, one case; Th10- 11, four cases; Th11-12, three cases and Th12-L1,two cases. Pre- and postoperative neurological status of all cases was ASIA A. In allcases, 5 levels of fixation were performed after reduction with posterior intervention.In addition, 2 patients died; specifically, one patient with thoracic trauma and one withembolism due to deep vein thrombosis at the third month post-op. Severe fusion wasobserved in 9 of our living patients and 1 had a moderate fusion.Conclusion: Acute thoracolumbar spondyloptosis can only be achieved via a posteriorapproach. The intense intercostal area can be used for a fusion bed.Öğe A Simple Technique for Removing Broken Pedicle Screws(2020) Seçer, Mehmet; Polat, Ömer; Çınar, Kadir; Ulutaş, MuratRemoving a broken pedicle screw is not always easy. Different methods and tools have been developed to remove the brokenscrew. Preserving the pedicle is an advantage for re-instrumentation. The head of the broken screw can be modified with the aid ofa high-speed drill and the screw can be removed using a fractured screw removal tool without any problems. In addition, performingthis procedure under the microscope reduces the risk of injury in the surrounding dura mater and the root. We believe that thissimple technique can be conveniently used while removing a broken pedicle screw.Öğe Spondylodiscitis in Patients under Haemodyalisis(2022) Kılıç, Güven; Polat, Ömer; Öneç, KürşadObjective: In addition to causing immunosuppression, hemodialysis may increase the risk of infection, given that the patients are more frequently exposed to vascular interventions and operative procedures. The present study aims to reveal the prevalence of spondylodiscitis in patients on hemodialysis, potential factors, and parameters that may help in the early diagnosis of the disease. Materials and Methods: Patients who received treatment in the hemodialysis unit between 2010 and 2020 were included in the present study. Data of patients with low back pain were obtained retrospectively from the Mia-Med patient registry system. Results: The frequency of spondylodiscitis was 2.3%. Findings showed that the prolonged dialysis duration (p<0.001), catheter use (p=0.005), diabetes mellitus (p=0.029), and heart failure (p=0.005) increased the risk of discitis. Leukocyte (p<0.001), neutrophil-to-lymphocyte ratio (NLR) (p=0.006), platelet-to-lymphocyte ratio (PLR) (p=0.001), sedimentation (p<0.001) and C-reactive protein (CRP) (p<0.001) levels were significantly higher in patients with spondylodiscitis. Conclusion: Spondylodiscitis occurs more prevalently in patients with comorbidity, have long hemodialysis duration, use catheters and in elderly patients. Leukocytosis, CRP, sedimentation can be used for rapid diagnosis. In addition, NLR and TLR, which can be easily calculated from the results of whole blood tests, are parameters that can be used in diagnosis.Öğe Tek Seviye Lomber Disk Hernisi ve Çok Seviyeli Lomber Spinal Stenoz Hastalarında Sistemik İnflamasyon Varlığının Araştırılması(2019) Polat, Ömer; Tuncer, CengizAmaç: Disk hernisi ve spinal stenoz varlığında semptomların gelişebilmesi için sinir kökünde inflamasyon ve irritasyonun olması gerektiği belirtilmektedir. Bu çalışmada inflamatuar değişikliklerin hastalık patogenezinde yer aldığı belirtilen tek seviye lomber disk hernisi ve çok seviyeli lomber spinal stenoz hastalarında sistemik inflamasyonun belirteçleri olarak kabul edilen nötrofil lenfosit oranı ve trombosit lenfosit oranını kullanarak bu iki hastalık arasındaki inflamatuar farklılığı ortaya koymak amaçlandı. Gereç ve Yöntem: Tek seviye lomber disk hernisi tanısı almış 50 hasta (31 kadın, 19 erkek), lomber spinal stenoz tanısı almış 50 hasta (34 kadın, 16 erkek) ve 50 sağlıklı birey (33 kadın, 17 erkek) oluşan kontrol grubu olarak çalışmaya dahil edildi. Üç grubun tam kan değerleri retrospektif olarak hastane verilerinden kaydedildi. Bulgular: Gruplar arasında nötrofil lenfosit oranı ve trombosit lenfosit oranını değerleri açısından istatistiksel olarak anlamlı bir farklılık vardı (sırasıyla, p<0.001, p=0.003). Kontrol grubunun değerleri diğer gruplara göre daha düşük olarak saptandı. Ayrıca lomber spinal stenoz grubunda nötrofil lenfosit oranı değerlerinin daha yüksek olduğu ve lomber disk hernisi grubu ile de istatistiksel olarak anlamlı bir fark olduğu tespit edildi (p<0.001). Sonuç: Nötrofil lenfosit oranı ve trombosit lenfosit oranını değerleri sinir dokusunda ortaya çıkan inflamasyonu değerlendirmekte kolay uygulanabilen ve düşük maliyetli tam kan sayımı verilerinden hesaplanarak elde edilen yeni belirteçlerdir. Kompresyona uğrayan sinir dokusunun artıp artmadığını anlamakta nötrofil lenfosit oranı hekime kolaylık sağlayabilir.Öğe Urgent operation improves weakness in cauda equina syndrome due to lumbar disc herniation(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Uçkun, Özhan M.; Alagöz, Fatih; Polat, Ömer; Divanlıoğlu, Denizhan; Dağlıoğlu, Ergün; Belen, A. Deniz; Dalgıç, AliObjectives: This study aims to examine the effect of surgical timing on the sphincter function and improvement of motor function in patients with 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 including demographics, muscle weakness, sensory deficit, sphincter control, LDH level, time from the initiation of symptoms to admission, and time to surgery were documented. The latest muscle weakness, sensory deficits, and sphincter control were also recorded. The patients were divided into two 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. Sphincter control resolved in five patients. Sensory loss resolved in two patients. While admission duration was shorter in the group with improved muscle strength (p=0.02), there was no significant difference in the time to surgery (p=0.63). Logistic regression analyses revealed that only the 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. On the other hand, patients with CES should be received surgery immediately when first seen, regardless of the time, since the muscle strength is slightly improved.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.Öğe The Use of Tissue-Selective Ultrasonic Aspirators in the Surgical Treatment of Brain and Spinal Cord Tumors(2019) Tuncer, Cengiz; Polat, Ömer; Duru, SonerAim: Ultrasonic surgical aspirators are surgical instruments operated with high frequencysound waves. The brain and/or spinal cord tumors can be removed safely with minimaldamaging to neurovascular structures by using tissue-selective ultrasonic aspirators. Besidesits benefits to the patient, by shortening the duration of operation, it may also provide costsavings in terms of hospital management. The aim of this study is to evaluate the utility andfeasibility of ultrasonic aspirator in central nervous system tumors.Material and Methods: Forty patients who apply to the Department of Neurosurgery at DuzceUniversity Medical Faculty between March 2013 and September 2017 due to brain or spinalcord tumor and operated for a brain or spinal cord tumor were included. Ultrasonic aspiratorwas used during the operations, and duration of operations were recorded.Results: The total operation time was compared between the groups that their operationsperformed by using ultrasonic aspirator and by not using it. The mean operation time wassignificantly higher in the group performed operations by using ultrasonic aspirator(253.8±87.5, 195.4±48.7, p=0.014). Whereas ultrasonic aspirator usage did not change theduration of operation in patients with glioblastoma (237.8±56.3, 235.5±31.9, p=0.689).Conclusion: Technological instruments, that become a part of surgical treatment, are devicesthat ensure maximum efficiency with minimum damage. However, these devices require priortraining on how to use them. Training of healthcare staff in the use of ultrasonic aspirator isvery important. Further studies are needed following the training of the assistant healthcarestaff in this subject.
