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Öğe Currarino syndrome: report of five consecutive patients(Springer, 2014) Duru, Soner; Karabağlı, Hakan; Türkoğlu, Erhan; Erşahin, YusufThe Currarino syndrome is regarded as a developmental disorder based on its recognized etiological heterogeneity. This syndrome is thought to result from abnormal separation of the neuroectoderm from the endoderm. Our aim was to report the neurosurgical management of Currarino syndrome in children and adults and to describe what clinician could do if the Currarino triad was suspected. We present five cases of Currarino triad who underwent surgical intervention. All patients had sacral bony deformity, anorectal malformations, and anterior sacral meningocele. A 40-year-old-male had chronic constipation. He was incidentally diagnosed with Currarino syndrome. A 19-year-old-female suffered from a slight weakness in lower extremities and urinary incontinence. Her past medical history was remarkable for anal atresia. The other three cases were children. When an anterior sacral meningocele is encountered, Currarino syndrome should be taken into consideration. Although it is rarity, the Currarino syndrome might be one of the causes of chronic constipation. Endoscopic or endoscope-assisted surgery via a posterior sacral route can be feasible for treatment of some of the patients with anterior sacral meningocele. Anterior meningocele pouch associated with Currarino syndrome will regresses over time following transdural ligation of its neck.Öğe The effect of etanercept on Spinal epidural Fibrosis in a Postlaminectomy Rat Model(2014) Türkoğlu, Erhan; Tuncer, Cengiz; Dinç, Cem; Serbes, Gökhan; Oktay, Murat; Şekerci, ZekiAMAÇ: Posterior spinal cerrahi sonrası duramatere yapışık epidural fibrozis formasyonu vücudun cerrahiye karşı vermiş olduğu normal bir reaksiyondur. Aşırı epidural fibrozis postlaminektomi sendromuna yol açan önemli nedenlerden biridir. Etanersept tümör nekrozis faktör alfayı inhibe ederek fibroblast migrasyonunu engeller ve sonuç olarak fibrozis gelişmesini önler. Bu çalışmanın amacı; topikal uygulanan etanerseptin rat laminektomi modelinde gelişen epidural fibrozis üzerine etkisini araştırmaktır. YÖNTEM ve GEREÇLER: 24 Wistar rat rastgele ve eşit olarak üç gruba (Kontrol, spongostan ve etanersept) ayrıldı. Bütün ratlara L3-L5 laminektomi yapıldı. Spongostana emdirilmiş salin (0.1mg/kg) ve etanersept (300 µg/kg) direkt duramatere uygulandı ve duramater üzerinde bırakıldı. 4 hafta sonra ratların T10-L5 arası omurgaları enblok olarak çıkartılarak, epidural fibrozis ve araknoidal tutulum histopatolojik olarak incelendi ve derecelendirildi. BULGULAR: Kontrol grubu ile karşılaştırıldığında topikal uygulanan etanersept grubunda epidural fibrozisin istatistiksel olarak anlamlı derecede azaldığı görüldü (p0.05). SONUÇ: Çalışmamız; topikal uygulanan etanerseptin laminektomi yapılmış ratlarda gelişen epidural fibrozisin azaltılmasında etkili olduğunu göstermiştir.Öğe The Effect of Etanercept on Spinal Epidural Fibrosis in a Postlaminectomy Rat Model(Turkish Neurosurgical Soc, 2014) Türkoğlu, Erhan; Tuncer, Cengiz; Dinç, Cem; Serbes, Gökhan; Oktay, Murat; Şekerci, ZekiAIM: The formation of epidural fibrosis adjacent to the dura mater after posterior spinal surgery is a normal reaction of the body to surgery. Extensive epidural fibrosis is one of the important causes of postlaminectomy syndrome. Etanercept inhibits tumor necrosis factor-alpha and decreases fibroblast migration. Thus, etanercept prevents the formation of fibrosis. The aim of this study was to investigate the effects of topical application of etanercept on epidural fibrosis after laminectomy in a rat model. MATERIAL and METHODS:Twenty-four Wistar rats were equally and randomly divided into three groups (control, spongostan and etanercept). Laminectomy was performed between L3 and L5 in all the rats. Spongostan soaked with saline (0.1 mg/kg) and etanercept (300 mu g/kg) was directly exposed to and left on the dura mater. Four weeks later, the vertebral columns of the rats were removed en bloc between T10 and L5, and epidural fibrosis and arachnoidal involvement were evaluated and graded histopathologically. RESULTS: Our data revealed that epidural fibrosis was reduced significantly in the rats treated with etanercept, compared to the control groups (p<0.05). CONCLUSION: Our study demonstrated that topical application of etanercept can be effective in reducing epidural fibrosis in rats after laminectomy.Öğe The Preventative Effect of ?-Tocopherol on Spinal Epidural Fibrosis After Laminectomy in a Rat Model(2019) Tuncer, Cengiz; Subası, Canan; Dinç, Cem; Türkoğlu, Erhan; Er, UyğurAIM: To assess the efficacy of ?-tocopherol as a topical antifibrotic agent on epidural fibrosis in lumbar laminectomy procedures.MATERIAL and METHODS: A total of 32 adult rats were assigned into four groups, with eight rats in each group. Standardlaminectomy was performed in every rat. In group 1, no treatment was administered after laminectomy. In group 2, a saline-soakedabsorbable gelatin sponge was left on the dura mater after laminectomy. In group 3, only ?-tocopherol was used on the dura materafter laminectomy. In group 4, a gelatin sponge soaked with ?-tocopherol was used after laminectomy. En bloc vertebral columnsbetween T10 and L5 were removed after sacrifice on postoperative day 30. Specimens were evaluated for degree of fibrosis andarachnoidal invasions.RESULTS: Statistically significant differences were found in the mean of fibrosis grades between groups (p=0.001). Differences inmean arachnoidal invasion were not statistically significant (p>0.05).CONCLUSION: Topical application of ?-tocopherol could effectively reduce the development of epidural fibrosis in an experimentallaminectomy model.Öğe Use of decorin to prevent epidural fibrosis in a post-laminectomy rat model(2014) Türkoğlu, Erhan; Dinç, Cem; Tuncer, Cengiz; Oktay, Murat; Serbes, Gökhan; Şekerci, ZekiThe formation of epidural fibrosis adjacent to the dura mater is a complex multi-step process that is associated with a marked reduction in tissue cellularity and the excessive deposition of extracellular matrix components. Extensive epidural fibrosis is a major cause of post-laminectomy syndrome. Decorin strongly inhibits fibrosis formation in various tissues via blockade of transforming growth factor-?1. The aim of this study was to investigate the effects of a topical application of decorin on the formation of epidural fibrosis in a rat laminectomy model. Twenty-four female Wistar albino rats (250-350 g) were equally and randomly divided into three groups (control, spongostan and decorin). Laminectomy was performed between the L3 and L5 levels in all rats. The dura mater was directly exposed to spongostan soaked with saline (2 cc/kg) or decorin (100 ?g/kg). Four weeks later, the laminectomized spine of the rats was completely removed between the L3 and L5 levels. The extent of the epidural fibrosis and arachnoidal involvement was histopathologically evaluated and graded. Our data revealed that epidural fibrosis was significantly reduced in the group treated with decorin compared to the spongostan and control groups (P<0.05). Our study demonstrates that the topical application of decorin can be effective in reducing the formation of epidural fibrosis in a simple laminectomy rat model. © 2013 Elsevier B.V.
