Ankylosing Spondylitis: Patterns of Spinal Injury and Treatment Outcomes

Study DesignRetrospective review.PurposeWe retrospectively reviewed our patients with ankylosing spondylitis (AS) to identify their patterns of spinal fractures to help clarify management strategies and the morbidity and mortality rates associated with this group of patients.Overview of LiteratureBecause of the brittleness of bone and long autofused spinal segments in AS, spinal fractures are common even after minor trauma and often associated with overt instability.MethodsBetween January 1, 1998 and March 2011, 30 patients (23 males, 7 females; mean age, 70.43 years; range, 45 to 95 years) with the radiographic diagnosis of AS of the spinal column had 42 fractures. Eight patients presented with significant trauma, 17 after falls, and 5 after minor falls or no recorded trauma. Eleven patients presented with a neurological injury, ranging from mild sensory loss to quadriplegia.ResultsThere were 16 compression and 10 transverse fractures, two Jefferson's fractures, one type II and two type III odontoid process fractures, and five fractures of the posterior spinal elements (including lamina and/or facet, three spinous process fractures, three transverse process fractures). Twenty-four fractures affected the craniocervical junction and/or cervical vertebrae, 17 were thoracic, and one involved the lumbar spine. The most affected vertebrae were C6 and T10. The mean follow-up was 29.9 months. One patient was lost to follow-up. Eighteen patients were treated conservatively with bed rest and bracing. Twelve patients underwent surgery for spinal stabilization either with an anterior, posterior or combined approach.ConclusionsNonsurgical treatment can be considered especially in the elderly patients with AS and spinal trauma but without instability or major neurological deficits. The nonfusion rate in conservatively treated patients is low. When treatment is selected for patients with spinal fractures and AS, the pattern of injury must be considered and the need for individualized treatment is paramount

Vitamin B complex and vitamin B 12 levels after peripheral nerve injury

The aim of the present study was to evaluate whether tissue levels of vitamin B complex and vitamin B 12 were altered after crush-induced peripheral nerve injury in an experimental rat model. A total of 80 male Wistar rats were randomized into one control (n = 8) and six study groups (1, 6, 12, 24 hours, 3, and 7 days after experimental nerve injury; n = 12 for each group). Crush-induced peripheral nerve injury was performed on the sciatic nerves of rats in six study groups. Tissue samples from the sites of peripheral nerve injury were obtained at 1, 6, 12, 24 hours, 3 and 7 days after experimental nerve injury. Enzyme-linked immunosorbent assay results showed that tissue levels of vitamin B complex and vitamin B 12 in the injured sciatic nerve were significantly greater at 1 and 12 hours after experimental nerve injury, while they were significantly lower at 7 days than in control group. Tissue level of vitamin B 12 in the injured sciatic nerve was significantly lower at 1, 6, 12 and 24 hours than in the control group. These results suggest that tissue levels of vitamin B complex and vitamin B 12 vary with progression of crush-induced peripheral nerve injury, and supplementation of these vitamins in the acute period may be beneficial for acceleration of nerve regeneration

Assessment of regeneration in peripheral nerve lesi{dotless}on compared with conventional suture technique and using cyanoacrylate (Ani{dotless}mal Experiment) Periferik sinir kesi tamirinde klasik sütur tekniǧi ile siyanoakrilat uygulamasi{dotless}ni{dotless}n regenerasyon üzerine etkilerinin araşti{dotless}ri{dotless}lmasi{dotless} (Hayvan Deneyi)

In this study, it was aimed to assess effect of classical micro-suturing techniques combined with cyanoacrylate, used in nerve repair, on nerve regeneration in histopathological manner and to evaluate whether it could be safely used in peripheral nerve surgery. Adult Wistar-Albino female rats were used in this study. Animals were assigned into 4 groups for surgical processes as follows: Group 1: Control group (n=7); External circumferential neurolysis Group 2: Experiment group (n=7); Repair with 4 epineural sutures. Group 3: Experiment group (n=7); Repair with cyanoacrylate Group 4: Experiment group (n=7); combined group Histopathologically, it was seen that there was no vacuolar degeneration, foreign body type tissue reaction or fibrosis in the nerves of subjects in the control group. Moreover, it was found that there were findings of vacuolar degeneration, foreign body type tissue reaction and fibrosis in all experiments group in a similar manner. However, it was found that there was a statistically significant difference regarding grade results of vacuolar degeneration, fibrosis and foreign body type tissue reaction between control group and classical suturing, cyanoacrylate or combined groups (p<0.05). In conclusion, it has been thought that cyanoacrylate is a feasible method for peripheral nerve surgery; as it can be easily applied at conditions where surgical suturing is challenging; it reduces the trauma exposed by nerve endings; it provides easy identification of nerve endings during secondary repair, which are contaminated and could not be primarily repaired; it shortens the procedure time; it is cost-effective and; it easy to learn

Chronic Subdural Hematomas: A Review of 94 Cases

Purpose: To investigate risk factors, preoperative findings, treatment, complications and prognosis of patients with chronic subdural hematoma treated in our university

Assessment of Regeneration in Peripheral Nerve Lesion Compared With Conventional Suture Technique and Using Cyanoacrylate (Animal Experiment)

In this study, it was aimed to assess effect of classical micro-suturing techniques combined with cyanoacrylate, used in nerve repair, on nerve regeneration in histopathological manner and to evaluate whether it could be safely used in peripheral nerve surgery. Adult Wistar-Albino female rats were used in this study. Animals were assigned into 4 groups for surgical processes as follows