If proximal ulnar nerve injuries are not intervened, it usually leads to irreversible and negative consequences. It results in motor and sensory defects in the areas innervated by the ulnar nerve and weakness in the intrinsic muscles of the hand. In patients with irreversible ulnar nerve damage due to cubital tunnel syndrome that have been left untreated for a long time, or proximal ulnar nerve injuries due to other reasons, the SETS method can restore especially the intrinsic functions of the hand. In this article, a patient with ulnar nerve damage that developed after benign tumor resection in the vicinity of the ulnar nerve, and the SETS operation and its results, which was performed for a patient whose ulnar functions did not return despite being followed with EMG for 1.5 years, are presented.
{"title":"Case Report of a Patient Who Underwent Supercharge end-to-side (SETS) Transfer for Proximal Ulnar Nerve Injury Using AIN (Anterior Interosseous Nerve) Motor Branch","authors":"E. Kütük, Özgür Baysal, W. Msangi","doi":"10.54306/sscd.2022.196","DOIUrl":"https://doi.org/10.54306/sscd.2022.196","url":null,"abstract":"If proximal ulnar nerve injuries are not intervened, it usually leads to irreversible and negative consequences. It results in motor and sensory defects in the areas innervated by the ulnar nerve and weakness in the intrinsic muscles of the hand. In patients with irreversible ulnar nerve damage due to cubital tunnel syndrome that have been left untreated for a long time, or proximal ulnar nerve injuries due to other reasons, the SETS method can restore especially the intrinsic functions of the hand.\u0000In this article, a patient with ulnar nerve damage that developed after benign tumor resection in the vicinity of the ulnar nerve, and the SETS operation and its results, which was performed for a patient whose ulnar functions did not return despite being followed with EMG for 1.5 years, are presented.","PeriodicalId":309697,"journal":{"name":"Sinir Sistemi Cerrahisi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126920654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amaç: Servikal spondilotik miyelopati (SSM) servikal vertebrada dejeneratif değişikliklere bağlı gelişen ve spinal kanalda stenoza neden olan nörolojik bir bozukluktur. Çok seviyeli SSM, servikal konjenital dar kanal ve posterior longitudinal ligaman ossifikasyonunda (PLLO) cerrahi tedavi seçimi tartışmalıdır. Çalışmamızda servikal laminoplastik cerrahi yöntemle opere edilen SSM’li hastaların cerrahi sonuçları “JOA” skorlama yöntemi kullanılarak değerlendirilecek ve yöntemin etkinliği literatür bilgileri eşliğinde tartışılacaktır. Yöntem: Hastanemiz Nöroşirurji kliniğinde 2014-2019 tarihleri arasında laminoplasti yöntemiyle opere edilen 8’i kadın, 17’si erkek toplam 25 SSM ve PLLO’lu hasta retrospektif olarak incelendi. Elde edilen sonuçlar “JOA” skorlama yöntemi kullanılarak değerlendirildi. İstatistiksel analiz için SPSS 15.0 for Windows programı kullanıldı. İstatistiksel alfa anlamlılık seviyesi p<0,05 olarak kabul edildi. Bulgular: Sonuçlar incelendiğinde preop JOA ortalaması 11,2±3,4 iken postop JOA ortalaması 14,5±2,1 olarak tespit edildi. Fark ortalaması 3,4±2,9 olarak bulundu ve bu sonuç istatistiksel olarak anlamlı idi (p<0,001). Çalışmamızda opere edilen SSM ve PLLO’lu toplam 25 olgunun uzun dönem takiplerinde 16 olguda klinik düzelme gözlendi, 8 olguda preop dönem ile karşılaştırıldığında fark izlenmedi, 1 olguda geçmeyen boyun ağrısı tespit edildi. Sonuç: Laminoplasti, SSM, PLLO ve diğer nedenlere bağlı olarak gelişen multipl seviyeli servikal stenoz tedavisinde giderek daha popüler hale gelmektedir. Diğer cerrahi yöntemler ile karşılaştırıldığında laminoplasti daha fizyolojik ve daha az komplikasyon oranlarına sahip olması nedeniyle özellikle çok seviyeli SSM ve PLLO’lu hastalarda en iyi seçenek gibi görünmektedir.
{"title":"Servikal Laminoplastide 25 Olguluk Deneyimimiz; Retrospektif Çalışma","authors":"İlhan Yılmaz, Osman Tanrıverdi","doi":"10.54306/sscd.2022.197","DOIUrl":"https://doi.org/10.54306/sscd.2022.197","url":null,"abstract":"Amaç: Servikal spondilotik miyelopati (SSM) servikal vertebrada dejeneratif değişikliklere bağlı gelişen ve spinal kanalda stenoza neden olan nörolojik bir bozukluktur. Çok seviyeli SSM, servikal konjenital dar kanal ve posterior longitudinal ligaman ossifikasyonunda (PLLO) cerrahi tedavi seçimi tartışmalıdır. Çalışmamızda servikal laminoplastik cerrahi yöntemle opere edilen SSM’li hastaların cerrahi sonuçları “JOA” skorlama yöntemi kullanılarak değerlendirilecek ve yöntemin etkinliği literatür bilgileri eşliğinde tartışılacaktır.\u0000Yöntem: Hastanemiz Nöroşirurji kliniğinde 2014-2019 tarihleri arasında laminoplasti yöntemiyle opere edilen 8’i kadın, 17’si erkek toplam 25 SSM ve PLLO’lu hasta retrospektif olarak incelendi. Elde edilen sonuçlar “JOA” skorlama yöntemi kullanılarak değerlendirildi. İstatistiksel analiz için SPSS 15.0 for Windows programı kullanıldı. İstatistiksel alfa anlamlılık seviyesi p<0,05 olarak kabul edildi.\u0000Bulgular: Sonuçlar incelendiğinde preop JOA ortalaması 11,2±3,4 iken postop JOA ortalaması 14,5±2,1 olarak tespit edildi. Fark ortalaması 3,4±2,9 olarak bulundu ve bu sonuç istatistiksel olarak anlamlı idi (p<0,001). Çalışmamızda opere edilen SSM ve PLLO’lu toplam 25 olgunun uzun dönem takiplerinde 16 olguda klinik düzelme gözlendi, 8 olguda preop dönem ile karşılaştırıldığında fark izlenmedi, 1 olguda geçmeyen boyun ağrısı tespit edildi.\u0000Sonuç: Laminoplasti, SSM, PLLO ve diğer nedenlere bağlı olarak gelişen multipl seviyeli servikal stenoz tedavisinde giderek daha popüler hale gelmektedir. Diğer cerrahi yöntemler ile karşılaştırıldığında laminoplasti daha fizyolojik ve daha az komplikasyon oranlarına sahip olması nedeniyle özellikle çok seviyeli SSM ve PLLO’lu hastalarda en iyi seçenek gibi görünmektedir.","PeriodicalId":309697,"journal":{"name":"Sinir Sistemi Cerrahisi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127865326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Altınel, E. Eşki, Gözde Özcan Söylev, İncila Öztop
In clinical practice, it may be difficult to differentiate brachial plexus schwannoma from pathological lymph nodes. Schwannoma is a relatively rare neoplasm arising from Schwann cells of the peripheral nerve sheath. Although it can occur in any organ, including the extremities, trunk, and head, it rarely presents as an axillary or supraclavicular lesion. In this the article, a 59-year-old male patient with painless swelling in the right supraclavicular fossa and cystic lymphadenopathy reported on USG is presented.
{"title":"A Mass in the Neck. Lymphadenopathy or Schwannoma?","authors":"F. Altınel, E. Eşki, Gözde Özcan Söylev, İncila Öztop","doi":"10.54306/sscd.2022.198","DOIUrl":"https://doi.org/10.54306/sscd.2022.198","url":null,"abstract":"In clinical practice, it may be difficult to differentiate brachial plexus schwannoma from pathological lymph nodes. Schwannoma is a relatively rare neoplasm arising from Schwann cells of the peripheral nerve sheath. Although it can occur in any organ, including the extremities, trunk, and head, it rarely presents as an axillary or supraclavicular lesion. In this the article, a 59-year-old male patient with painless swelling in the right supraclavicular fossa and cystic lymphadenopathy reported on USG is presented.","PeriodicalId":309697,"journal":{"name":"Sinir Sistemi Cerrahisi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129646387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: In this study, we aimed to analyze the properties of drained subdural fluid and post-operative follow-up of patients with chronic subdural hematoma subdivided randomly into two groups according to presence or absence of dexamethasone treatment. Material and Methods: 42 patients with chronic subdural hematoma were involved in this study. The patients were divided into two groups according to dexamethasone treatment. 21 of the patients were treated with dexamethasone. All patients underwent burr hole craniotomy and a closed system drainage was constructed. The amount and properties of per-operative versus post-operative drained subdural fluid (hemoglobin, total protein and albumin levels) were analyzed. Cranial computerized tomography scans were used for follow-up and presence of fluid collection in subdural space was controlled. Results: When compared to per-operative laboratory results, statistically significant decrease was observed in both groups. However, the decrease in dexamethasone group was more significant compared to none-dexamethasone group. Follow-up computerized tomography results showed rare new subdural fluid collection development in dexamethasone group. Conclusion: As a result, Our findings suggest that surgery with dexamethasone treatment in chronic subdural hematoma patients has a more favourable clinic result compared to surgery without dexamethasone treatment.
{"title":"The Effects of Dexamethasone Used in the Treatment of Chronic Subdural Hematoma","authors":"Y. Navruz, Erek Öztürk, A. Iplikcioglu","doi":"10.54306/sscd.2022.202","DOIUrl":"https://doi.org/10.54306/sscd.2022.202","url":null,"abstract":"Aim: In this study, we aimed to analyze the properties of drained subdural fluid and post-operative follow-up of patients with chronic subdural hematoma subdivided randomly into two groups according to presence or absence of dexamethasone treatment.\u0000Material and Methods: 42 patients with chronic subdural hematoma were involved in this study. The patients were divided into two groups according to dexamethasone treatment. 21 of the patients were treated with dexamethasone. All patients underwent burr hole craniotomy and a closed system drainage was constructed. The amount and properties of per-operative versus post-operative drained subdural fluid (hemoglobin, total protein and albumin levels) were analyzed. Cranial computerized tomography scans were used for follow-up and presence of fluid collection in subdural space was controlled.\u0000Results: When compared to per-operative laboratory results, statistically significant decrease was observed in both groups. However, the decrease in dexamethasone group was more significant compared to none-dexamethasone group. Follow-up computerized tomography results showed rare new subdural fluid collection development in dexamethasone group.\u0000Conclusion: As a result, Our findings suggest that surgery with dexamethasone treatment in chronic subdural hematoma patients has a more favourable clinic result compared to surgery without dexamethasone treatment.","PeriodicalId":309697,"journal":{"name":"Sinir Sistemi Cerrahisi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127027903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osman Boyalı, Onur Öztürk, Furkan Diren, Eyüp Can Savrunlu, Serdar Kabataş, Erdinç Civelek, Yavuz Aras
“Endoskop”; içeri, içeriye anlamına gelen “endo” ve görmek, görüntülemek anlamına gelen “skope” kelimelerinin birleşmesi ile oluşan Yunanca kökenli bir kelimedir. Nöroşirurji alanında endoskop ilk olarak ventrikül içi patolojilerin ve hidrosefalinin tedavisinde kullanılmıştır. Başarısız cerrahi girişimler nedeniyle gündemden düşen nöroendoskop ilerleyen zamanlarda mikrocerrahiye yardımcı olması amacıyla yeniden kullanıma girmiştir.
{"title":"Nöroendoskopi – Ekipmanlar, Kullanım ve Çalışma İlkeleri","authors":"Osman Boyalı, Onur Öztürk, Furkan Diren, Eyüp Can Savrunlu, Serdar Kabataş, Erdinç Civelek, Yavuz Aras","doi":"10.54306/sscd.2022.201","DOIUrl":"https://doi.org/10.54306/sscd.2022.201","url":null,"abstract":"“Endoskop”; içeri, içeriye anlamına gelen “endo” ve görmek, görüntülemek anlamına gelen “skope” kelimelerinin birleşmesi ile oluşan Yunanca kökenli bir kelimedir. Nöroşirurji alanında endoskop ilk olarak ventrikül içi patolojilerin ve hidrosefalinin tedavisinde kullanılmıştır. Başarısız cerrahi girişimler nedeniyle gündemden düşen nöroendoskop ilerleyen zamanlarda mikrocerrahiye yardımcı olması amacıyla yeniden kullanıma girmiştir.","PeriodicalId":309697,"journal":{"name":"Sinir Sistemi Cerrahisi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123926037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Yakar, E. Egemen, E. Çeltikçi, Ş. Hanalioğlu, B. Bakırarar, Ü. A. Dere, Yücel Doğruel, Abuzer Güngör
Objective: The term big data refers to high volumes of data that are difficult to store, process, and analyze through traditional database technologies. This paper aims to discover the big data knowledge and awareness of Turkish neurosurgeons. Methods: An online survey link was sent to all members of the Turkish Neurosurgical Society (n=1707 neurosurgeons) by e-mail. The survey, which was available during September and October 2021, was filled by 211 specialists (12.4%) neurosurgeons. Participants were scored based on the questions asked in “Big Data” and the scores were compared with baseline characteristics.There was no statistically significant correlation between baseline characteristics (age, gender, the residency/current institution, academic title, the presence of a Ph.D. degree, and professional specialist period) and survey score. The survey scores of the participants who used a big data platform, wrote code, thought that the use of big data was beneficial, and wanted to learn more about this subject were statistically significantly higher. Conclusions: Obtaining information about big data seems to be related only to personal interests. Necessary arrangements should be made in the training programs of neurosurgeons on this topic, which is gaining in popularity and provides useful information for daily clinical practice.
{"title":"The Big Data Awareness of Turkish Neurosurgeons: A National Survey","authors":"F. Yakar, E. Egemen, E. Çeltikçi, Ş. Hanalioğlu, B. Bakırarar, Ü. A. Dere, Yücel Doğruel, Abuzer Güngör","doi":"10.54306/sscd.2022.200","DOIUrl":"https://doi.org/10.54306/sscd.2022.200","url":null,"abstract":"Objective: The term big data refers to high volumes of data that are difficult to store, process, and analyze through traditional database technologies. This paper aims to discover the big data knowledge and awareness of Turkish neurosurgeons.\u0000Methods: An online survey link was sent to all members of the Turkish Neurosurgical Society (n=1707 neurosurgeons) by e-mail. The survey, which was available during September and October 2021, was filled by 211 specialists (12.4%) neurosurgeons. Participants were scored based on the questions asked in “Big Data” and the scores were compared with baseline characteristics.There was no statistically significant correlation between baseline characteristics (age, gender, the residency/current institution, academic title, the presence of a Ph.D. degree, and professional specialist period) and survey score. The survey scores of the participants who used a big data platform, wrote code, thought that the use of big data was beneficial, and wanted to learn more about this subject were statistically significantly higher.\u0000Conclusions: Obtaining information about big data seems to be related only to personal interests. Necessary arrangements should be made in the training programs of neurosurgeons on this topic, which is gaining in popularity and provides useful information for daily clinical practice.","PeriodicalId":309697,"journal":{"name":"Sinir Sistemi Cerrahisi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133199700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-25DOI: 10.54306/sscd.2021.29981
Murat Kiraz
Background: Intradural disc herniation (IDH) is rare and is thought to be caused by posterior longitudinal ligament and posterior adhesions. MRI findings are inadequate for definitive diagnosis. We reported a patient with an L4-5 IDH and reviewed the literature. Case Description: A 71-year-old male patient presented with acute exacerbation of right lower extremity radiculopathy. MRI with/without contrast suggested IDH and spinal cord compression at the L4-5 spine level. While elective surgery was planned for the patient who did not have motor deficits at the time of admission, he underwent emergency surgery due to sudden urinary incontinence. At surgery, the disc herniation was appropriately resected, the dura was closed. Conclusion: Although MRI is helpful in the diagnosis of IDH, the definitive diagnosis is made intraoperatively. In surgery, both the extradural and intradural disc components should be removed and as small laminectomy and dura incision as possible.
{"title":"Intradural disc herniation: A case report and literature review","authors":"Murat Kiraz","doi":"10.54306/sscd.2021.29981","DOIUrl":"https://doi.org/10.54306/sscd.2021.29981","url":null,"abstract":"Background: Intradural disc herniation (IDH) is rare and is thought to be caused by posterior longitudinal ligament and posterior adhesions. MRI findings are inadequate for definitive diagnosis. We reported a patient with an L4-5 IDH and reviewed the literature. Case Description: A 71-year-old male patient presented with acute exacerbation of right lower extremity radiculopathy. MRI with/without contrast suggested IDH and spinal cord compression at the L4-5 spine level. While elective surgery was planned for the patient who did not have motor deficits at the time of admission, he underwent emergency surgery due to sudden urinary incontinence. At surgery, the disc herniation was appropriately resected, the dura was closed. Conclusion: Although MRI is helpful in the diagnosis of IDH, the definitive diagnosis is made intraoperatively. In surgery, both the extradural and intradural disc components should be removed and as small laminectomy and dura incision as possible.","PeriodicalId":309697,"journal":{"name":"Sinir Sistemi Cerrahisi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127697716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-25DOI: 10.54306/sscd.2021.14237
Furkan Diren, Osman Boyalı, Eyüp Can Savrunlu, E. Civelek, S. Kabataş
Background: It is known that interactions between programmable Ventriculoperitoneal Shunt (VPS) valves and electromagnetic and hearing devices may change the valve settings. We reported a patient using programmable VPS valves and hearing devices and reviewed the literature. Case Description: A 71-year-old man was implanted with a programmable VPS valve with the diagnosis of Normal Pressure Hydrocephalus. A hearing device (behind-the-ear) was proposed because of hearing difficulties, but it was suggested that it be discontinued because it did not help. However, the patient used it twice because of his current dementia, forgetting the doctor’s recommendations. The setting of the valve has changed in these two different times that this behind-the-ear hearing device is used. Long-term follow-ups showed no change in valve settings except those two situations. Conclusion: It is important to note that patients using hearing devices and programmable VPS valves are a unique group of patients. There are not enough studies showing the relationship between the behind-the-ear hearing devices and programmable VPS. It should be kept in mind that hearing devices with magnetic field strength may change the setting of the valves.
{"title":"Programmable shunt valve affected by behind-the-ear hearing device: A case report and literature review","authors":"Furkan Diren, Osman Boyalı, Eyüp Can Savrunlu, E. Civelek, S. Kabataş","doi":"10.54306/sscd.2021.14237","DOIUrl":"https://doi.org/10.54306/sscd.2021.14237","url":null,"abstract":"Background: It is known that interactions between programmable Ventriculoperitoneal Shunt (VPS) valves and electromagnetic and hearing devices may change the valve settings. We reported a patient using programmable VPS valves and hearing devices and reviewed the literature. \u0000Case Description: A 71-year-old man was implanted with a programmable VPS valve with the diagnosis of Normal Pressure Hydrocephalus. A hearing device (behind-the-ear) was proposed because of hearing difficulties, but it was suggested that it be discontinued because it did not help. However, the patient used it twice because of his current dementia, forgetting the doctor’s recommendations. The setting of the valve has changed in these two different times that this behind-the-ear hearing device is used. Long-term follow-ups showed no change in valve settings except those two situations. \u0000Conclusion: It is important to note that patients using hearing devices and programmable VPS valves are a unique group of patients. There are not enough studies showing the relationship between the behind-the-ear hearing devices and programmable VPS. It should be kept in mind that hearing devices with magnetic field strength may change the setting of the valves.","PeriodicalId":309697,"journal":{"name":"Sinir Sistemi Cerrahisi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121554684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-25DOI: 10.54306/sscd.2021.51423
Ilhan Aydin, Melih Üçer
Amaç: Lomber disk hernisi, lomber intervertebral disklerin anulus fibrozlarının yırtılarak nukleus pulpozusun dışarı taşması sonucunda omurilik veya köklerin basıya uğramasıdır. Nüks lomber disk hernisi diskektomi cerrahisi sonrası en az 6 ay süreyle ağrısı geçen hastada aynı seviyede aynı taraf veya karşı tarafta disk herniasyonu gelişmesidir. Günümüzde nüks lomber disk herniasyonlarının görülme sıklığı farklı serilerde %5-15 aralığında bildirilmiştir. Bu çalışmamızda nüks lomber disk hernisi nedeniyle opere edilen olguların ilk operasyon öncesi yapılan radyolojik tetkiklerle ikinci operasyon (nüks) öncesi yapılan radyolojik tetkikleri kıyaslanarak nüks disk hernisi patofizyolojisindeki değişiklikler retrospektif olarak değerlendirildi. Yöntem: Çalışmamızda retrospektif olarak nüks lomber disk hernisi tanısı ile ikinci kez opere edilen 50 olgunun ilk preoperatif ve ikinci preoperatif radyolojik tetkiklerdeki (lomber direk grafileri ve lomber MRG) değişikliklerin patofizyoloji açısından değerlendirilmesi yapılmıştır. Bulgular: Çalışmaya alınan 50 hastanın ilk operasyon öncesi ve ikinci operasyon öncesi direkt radyografi ve MRG bulguları karşılaştırıldı. İleri yaş erkek hastalar, geniş tabanlı protrude diski olan, ileri derecede dejenerasyona sahip disk ve faset ekleme sahip hastalarda nüks oranı daha fazla bulundu. Sonuç: Nüks lomber disk herniasyonu beyin cerrahları ile hastaları karşı karşıya getiren önemli bir sorundur. Preoperatif dönemde bakılacak bazı parametreler ile hastanın nüks oranının daha fazla olduğunu öngörmek ve hastayı bu yönde bilgilendirmek, ilerde oluşabilecek nüks sonrası süreci daha iyi ve olumlu yönetmemizi sağlayacaktır.
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Pub Date : 2022-01-25DOI: 10.54306/sscd.2021.74745
Veysel Kıyak
Kafa travmaları, mortalite ve morbiditenin önemli bir sebebi olmasının yanı sıra, engellenebilir olmaları yönüyle de ele alınması gerekli olan bir sorundur. Ülkemizde de dünyadaki verilere benzer şekilde, sanayileşmenin artması ve bunun sonucunda trafik kazaları, iş kazalarının (yüksekten düşme gibi) kafa travmalarının en sık görülen sebepleri olarak karşımıza çıktığı görülmektedir. Bu çalışmada kafa travması ile başvuran ve epidural hematom saptanan hastalar epidemiyolojik açıdan incelenmiştir.
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