Comparison of Wiltse and classical methods in surgery of lumbar spinal stenosis and spondylolisthesis

Aim Minimally invasive approaches to posterior lumbar surgery are available today that can enhance patient comfort by greatly reducing tissue damage and offer better clinical results. However, such methods have not yet gained widespread popularity despite their significant advantages. This study compares the Wiltse method and the classical method of lumbar surgery based a cohort, clinical study of 57 patients. The patients all had degenerative lumbar spinal stenosis and/or spondylolisthesis and had developed multifidus muscular atrophy. Materials and methods We enrolled 57 patients admitted to our clinic between April 2012 and September 2013 with a diagnosis of degenerative lumbar spinal stenosis and/or spondylolisthesis. These were treated with the classic posterior approach (n=26) or the Wiltse method (n=31). Findings In the classical method group, the ratio of female to male patients was 20/6 and the mean age was 58.19±10.17 years. A comparison of preoperative and postoperative multifidus muscle cross-sectional measurements (average of right and left) revealed a 36.09% atrophy level in the classical method group and a 26.34% atrophy level in the Wiltse group (p<0.01). However, atrophy development was 18.82% higher in the classical method group (p<0.05) relative to the Wiltse group. Conclusion The Wiltse method is less invasive and causes less tissue damage. It reduces the change of hemorrhage and multifidus muscles and offers a shorter duration of hospitalization with less pain

Chronic Subdural Hematomas: Epidemiology, Radiology, Hematological Parameters and Surgical Results of Cases

Aim: Chronic Subdural hematomas (CDSH) first reported in 1656 by JJ Wepfer. In 1857 CSDH was defined as Pachimenengitis hemoragyca interna. Frequency of CSDH changes with age progression. İt’s reported in literature; CDSH coexists %60-80 with minor head trauma. We aimed to present our experience in follow-up and treatment of patients with CSDH which are frequently encountered in routine neurosurgical practice. Materials and Methods: Cases of CSDH which were operated between January 2016- December 2017 evaluated retrospectively from Clinical Files. The patients' clinical files were evaluated retrospectively according to age, gender, personal background, complaint, use of anticoagulant, presence of head trauma, radiologic images, hematologic parameters, type of anesthesia, surgical method and recurrence rates.Results: The study consists of total 67 cases which %20,9 (n=14) female and %79,1 (n=53) male. The ages of the cases ranged from 16 to 91 years with an average of 68,60 ± 16,45 years. The duration of hospitalization according to gender and age, the duration of hospitalization according to the presence of additional disease and the types of additional diseases seen, the duration of hospitalization according to drug use and anesthesia type (p> 0.05), between N / L and residence time (r: 0,222; p > 0.05) were not statistically significant.Conclusions: However, it may seem so basic; Choices about Surgical techniques and type of anesthesia are effective about mortality and morbidity. Because of duration of surgery is shorter; it is shown that Surgeries performed with Sedoanalgesia and local anesthesia can be used safely especially for patients with comorbidity

Combined Therapy for Distant Metastasis of Sacral Chordoma

Chordomas are known as rare primary malign tumours that have formed from primitive notochord remains. Sacral chordomas grow slowly but locally and aggressively. Chordomas are locally invasive and have low tendency to metastasis and have a poor prognosis in long-term follow-up. Metastasis may be seen in a rate of 5–40% of the chordomas. Metastasis of chordomas is common in liver, lung, lymph nodes, peritoneum, and brain. The treatment approaches, including surgery, have been discussed in the literature before. Susceptibility to radiotherapy and chemotherapy is controversial in these tumours. The success of surgical treatment affects survival directly. In this report, we will report a sacral chordoma case in which an intraperitoneal distant metastasis occurred and discuss the surgical approach

Thoracolumbar burst fractures requiring instrumented fusion: Should reducted bone fragments be removed? A retrospective study

Conclusion: Retropulsion of free bone fragments extend the time of surgery and causes complications. This study found that there is no need to retropulse the bone fragments in the spinal canal in patients with unstable burst fractures who underwent total laminectomy and posterior long segment stabilization. (C) 2015 Polish Neurological Society. Published by Elsevier Sp. z o.o. All rights reserved

A Retrospective Study of 39 Patients Treated With Anterior Approach of Thoracic and Lumbar Spondylodiscitis Clinical Manifestations, Anterior Surgical Treatment, and Outcome

The aim of this study is to report our 39 patients treated with anterior debridement and autologous iliac bone grafting with or without anterior instrumentation, which is the presumed treatment of choice for thoracic or lumbar spondylodiscitis.Our patients underwent surgical treatment of spondylodiscitis using anterior debridement and autologous iliac bone grafting with or without anterior instrumentation and were analyzed with a mean follow-up of 8 years (range, 2-11 years). Kaneda 2-rod system instrumentation was used in 12 patients, in total. Clinical outcomes were assessed by the Frankel grade. Radiographic fusion was characterized based on 3-dimensional computed tomography.Of the whole group, 20 patients suffered from tuberculous spondylodiscitis and 19 suffered from hematogenous spondylodiscitis. Pathogens responsible for pyogenic infection included Staphylococcus aureus (4 patients), Pseudomonas aeruginosa (3 patients), and Brucella melitensis (1 patient). Fifteen patients had thoracic involvement, 20 had lumbar involvement, and 4 had thoracolumbar junction involvement. Preoperative neurological deficits were noted in 13 of the 39 patients. In terms of Frankel grade, 8 patients have improved, 4 have remained the same, and 1 patient has worsened during the follow-up period. Imaging-documented fusion was achieved in 23 of 27 patients in the graft group (85% fusion rate) and 11 of 12 patients in the graft+Kaneda instrumentation group (91% fusion rate).There was no instrumentation failure, loosening, or graft-related complication such as slippage or fracture of the graft. This approach demonstrated a good recovery rate of neurological functions and a high fusion rate

Pnömonektomi: Endikasyon ve sonuçları

AMAÇ: Göğüs cerrahisinde pnömonektomi ameliyatları yüksek mortalite ve morbidite ile birliktedir. Çalışmada, pnömonektomi uygulanan hastaların endikasyonları ve cerrahi tedavi sonuçlarının gözden geçirilmesi amaçlandı. GEREÇ-YÖNTEM: Çalışmaya Ocak 2003-Aralık 2004 arasında pnömonektomi uygulanan 72 hasta dahil edildi. Tüm hastalar endikasyon, hasta özellikleri, operatif mortalite ve postoperatif komplikasyonlar yönünden incelendi. BULGULAR: Çalışma grubu 68'i (%94.4) erkek, 4'ü (%5.6) kadın 72 hastadan ibaretti. Yaş ortalaması 56.8±11.0 (20 ile 77 arası) idi. Hasta tanıları şöyleydi; 65 (%90.3) akciğer kanseri, 3 (%4.1) aspergillom, 2 (%2.8) bronşektazi, 1 (%1.4) endobronşial hamartom ve 1 (%1.4) tüberküloz. Tüm hastalardan 16?sına (%22.2) neoadjuvan tedavi uygulandı. Üç hastaya (%4.2) ilave göğüs duvarı rezeksiyonu yapıldı. Üç hastada intraperikardial pnömonektomi gerekti. Operatif mortalite oranı %6.9 idi (5 hasta). On üç hastada (%18.1) komplikasyon gelişti; 4 aritmi, 4 solunum yetmezliği, 3 ampiyem, 2 bronkoplevral fistül, 2 kord vokal paralizisi, 2 emboli, 1 kalp yetmezliği, 1 pnömotoraks, 1 özefagus rüptürü, 1 akciğer ödemi ve 1 renal yetmezlik. Altmış yaş üstü (p=0.01), neoadjuvan tedavi almış (p=0.03), ek hastalığı olan (p=0.0008) ve genişletilmiş rezeksiyon uygulanan (p=0.008) hastalar artmış komplikasyon oranına sahipti. Operatif mortalite oranı ise 60 yaş üstü (p=0.014), ek hastalığı olan (p=0.0004) ve genişletilmiş rezeksiyon uygulananlarda (p=0.05) istatistiksel olarak anlamlı derecede daha yüksek orandaydı. SONUÇ: Çalışmamızda yaş, genişletilmiş rezeksiyon, ek hastalık ve neoadjuvan tedavi uygulanması komplikasyon oranına etkili bağımsız değişkenlerdi. Yaş, ek hastalık ve genişletilmiş rezeksiyonlar ise artmış operatif mortalite ile birlikteydi

The Score for Allergic Rhinitis study in Turkey, 2020

International audienceObjective: This study aimed to determine how prevalent allergic rhinitis (AR) is in Turkey and to compare the current prevalence with the figures obtained 10 years earlier.Methods: This study included 9,017 participants. The minimum number of participants required from each center was determined via a stratified sampling technique according to regional demographic characteristics as ascertained from the last census. For each region, both men and women were administered the score for allergic rhinitis (SFAR) questionnaire and a score for each participant was calculated based on the responses supplied.Results: A total of 9,017 individuals (55.3% men and 44.7% women) took part in this study. Of these, 94.4% were urban residents and 5.6% lived in a rural setting. Of the men, 38.5% self-reported as suffering from AR. The corresponding figure in women was 40.5%. The overall prevalence of AR, as deduced on the basis of the SFAR, was found to be 36.7%. Comparing the prevalence in different regions, we found that AR was the least prevalent in the Black Sea region with a frequency of 35.8%. The highest prevalence was in the Mediterranean region, where the prevalence was 37.7%. There was no statistical significance in the apparent differences in prevalence between different geographical regions. Despite this, however, there was a clear increase in the frequency of AR over the preceding decade. This increase was most pronounced in the South-Eastern Anatolian region, where the frequency rose from 21.0% to 36.9%.Conclusion: Our results indicate that there has been a marked increase in the prevalence of AR in every region in Turkey over the last 10 years. This could be related to living conditions in urban environments. Alterations in lifestyle, urban living, air pollution causing impairments in immune defense mechanisms, and other aspects of modern lifestyles may account for the increase in AR in Turkey