How does the side of lumbar disc herniation influence the psoas muscle size at the L4-5 level in patients operated for unilateral hip arthroplasty?

Study Design: Retrospective study. Objection: There can be a relationship between degenerative diseases in the spine and hip. Summary of Background Data: Degenerative diseases in the spine and hip may occur concomitantly. This study was done to investigate the cross-sectional area of psoas muscle size and incidence of lumbar disc herniation after unilateral hip arthroplasty. Methods: The data files of patients who were operated on for unilateral hip arthroplasty between January 2014- and 15 May 2021 at the Recep Tayyip Erdogan University Hospital were retrospectively analysed for the relationship between the psoas muscle volume and the incidence of lumbar disc herniation. The patients were divided according to their operated sides. Results: The data files of 48 patients were retrospectively analysed. The patients were divided into two groups according to the operated side of their hip joints. Gender and age differences were not significant, and the mean ages were 68,68 years old in the right hip arthroplasty group, and 69,39 in the left hip arthroplasty group. Conclusions: A complex interaction between the development of lumbar disc herniations and increased contralateral cross-sectional area of the psoas muscle at the L4-5 level was observed in patients operated for unilateral hip arthroplasty. This interaction can be a compensatory mechanism to counteract the spinal imbalance

Interesting negative correlation between transorbital optic nerve sheath diameter and Evans' index values; can it be predictive for failure of endoscopic third ventriculostomy?

Background: Currently, Endoscopic third ventriculostomy (ETV) is one of the commonly used surgical options for the treatment of non-communicating hydrocephalus but reported success rates from ETV vary considerably, and a reliable noninvasive means to detect the efficacy of ETV is still lacking. In this study, the changes in Evans's Index and the transorbital optic nerve sheath (ONSD) diameter measurement after endoscopic third ventriculostomy were compared. Methods: Preoperative and early postoperative ultrasonographic ONSD measurement and preoperative and postoperative 3 months Evans' index of patients with hydrocephalus on whom ETVs were performed between 1 February 2018 and 23 May 2022 and analyzed. Results: The chart of 8 male and 2 female patients was analyzed. Their median age at presentation was 5.3 years (range 1 - 14 years). Mean ONSD values were 5.66 mms in the preoperative period, which was decreased to a mean of 4.17 mms in the early postoperative period. The Evans' index was 0.5320 in the preoperative period; however, it decreased to 0.4460 in the postoperative 3rd months. The preoperative and early postoperative mean ONSD values and Evans' Index of patients were significantly different. Interestingly, a negative correlation was also observed between ONSD values and Evans' index. Conclusions: ONSD measurement and Evans' index have been commonly used after ETV procedures In pediatric patients with hydrocephalus. Still, there is an unexplained negative correlation between ONSD and Evans' index values. This study indicates that the two measures (Evans's index and ONSD) should be considered when performing follow-up examinations in patients after ETV

Does the anesthesia technique of cesarean section cause persistent low back pain after delivery? A retrospective analysis

Objective Cesarean sections (CS) under spinal anesthesia may lead to newly developed low back pain (LBP) after anesthesia. The cause of this pain is still unknown. This subject was investigated. Methods The persistent LBP after the section was retrospectively analyzed in patients who were operated on under spinal or general anesthesia between January 1, 2018, and January 1, 2020. Result General anesthesia was used in 52 women, but 251 women were operated on under spinal anesthesia. Newly developed persistent LBP was detected in 57 (18,8%) of a total of 303 patients. Of those patients with LBP, general anesthesia was used in 14 of 52 (26,9%) patients, but 43 of 251 (17.1%) patients received spinal anesthesia. Baby weight after CS was the only variable associated with persistent LBP after 3 and 6 months (P 0.05). Conclusion This study shows anesthesia type as spinal or general was not associated with increased persistent LBP. Performing more spinal than general anesthesia in the cesarean section may be false data about the increased rate of LBP after CS

Effects of Metoprolol on Experimental Spinal Cord Ischemia-Reperfusion Injury in Rats

Aim: The aim of this study was to investigate the neuroprotective effect of metoprolol and its efficacy in reducing lipidperoxidation levels in the spinal cord ischemia-reperfusion model in rats.Material and Methods: Twenty (20) Sprague-Dawley female rats weighing between 220 gr and 280 gr were randomlydivided into 3 groups. Only laparotomy was performed in the control group, and the aorta abdominalis was revealed. Inthe groups other than the control group, clip compression was applied to the aorta abdominalis for 45 minutes. Theischemia group was not given any medication. Metoprolol was administered intraperitoneally at 0.5 mg/kg to themetoprolol group. Motor examination was made according to Tarlov scale at the 1st and 24th hours and then, spinalcords of all rat models were removed. Spinal cord tissue samples were collected for histopathological examination andfor determining malondialdehyde (MDA) level. All rats were sacrificed by draining blood after their motorexaminations.Results: According to motor examination findings at the 1st and 24th hours, metoprolol resulted in a statisticallysignificant improvement in recovery (p=0.045). Histopathological examinations revealed that metoprolol contributed toneurological recovery by reducing neuronal necrosis. MDA levels, which is an indicator of lipid peroxidation, weresignificantly lower in the metoprolol group when compared to the ischemia group (p=0.001).Conclusion: Metoprolol was found to be significantly effective in reducing and/or preventing spinal cord ischemiareperfusion injury

Important finding for COVID-19 pandemic; Hydrocephalus producing effect of vaporised alcohol disinfectant

Background: Alcohol exposure may cause hydrocephalus. In this study, the effect of vaporized nasal alcohol exposure on the choroid plexus, ependymal cells, and developing hydrocephalus was investigated. METHODS: 24 males (∼380g) Wistar rats were used in this study. Animals were divided into three groups, as the control, SHAM and study groups. Then, the study group was again divided into two groups as exposed to light or heavy dose alcohol. The choroid plexuses and intraventricular ependymal cells and ventricles volumes were assessed and compared. RESULTS: Degenerated epithelial cells density 22±5 /mm3in the control group, 56±11 /mm3in the SHAM group, 175±37 /mm3in the light, and 356±85 /mm3in the heavy alcohol exposure group. Evan's index was less than [removed]36% in the SHAM, larger than >40% in the group which was exposed to light alcohol (light alcohol group), larger than >50% in heavy alcohol (heavy alcohol group) exposed. CONCLUSIONS: It was found that alcohol exposure causes choroid plexus and ependymal cell degeneration with ciliopathy and the enlarged lateral ventricles or hydrocephalus. In the COVID-19 Pandemic Era, our findings are functionally important; alcohol has often been used for hygiene and prevention of transmission of COVID-19 pandemic