Yazar "Özveren, Mehmet Faik" seçeneğine göre listele

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    Öğe
    Alt servikal omurga dislokasyonlarında olası prognostik belirteçler
    (2019) Öğden, Mustafa; Özdemir, Alemiddin; Yüksel, Ulaş; Bakar, Bülent; Özveren, Mehmet Faik
    Amaç: Bu çalışmanın amacı prognozlarını etkileyen faktörleri belirlemeye yönelik olarak servikal dislokasyon tespit edilen hastaların tedavi sonuçlarını incelemektir.. Gereç ve Yöntem: Bu çalışmada servikal dislokasyon nedeniyle opere edilen hastaların yaş, cinsiyet, dislokasyon sebebi, “Japanese Orthopedic Association (JOAS)” ölçeği puanı, dislokasyon gelişen omurga seviyesi, faset kilitlenmesi, spondilolistesiz derecesi, cerrahi tedavi bilgileri, yoğun bakım ünitesine (YBU) ve hastane tedavi bilgileri ve hastaneden ayrılış nörolojik düzeylerine ait bilgiler (Modifiye Rankin Skalası, mRS) geriye dönük incelendi. Bulgular: Çalışmaya alınan 13 hastada dislokasyonun çoğunlukla faset kırığına ikincil C5-6 ve C6-7 segmentlerinde oluştuğu görüldü. Çoğu hastada (9 tane) anterior yaklaşımla omurga stabilizasyonu yapıldığı, hastaların %50 kadarında çok seviyeli stabilizasyon uygulandığı saptandı. Korelasyon analizi sonunda JOAS puanları düşük olduğunda spinal şok gelişme olasılığının, ventilatör desteği ihtiyacının, YBU kalma süresinin ve mRS puanlarının artabileceği öngörüldü. Spondilolistezis derecesi arttığında stabilizasyon uygulanan omurga sayısının, ventilatör desteği ihtiyacının, YBU ve hastanede kalma süresinin artabileceği düşünüldü. Spinal şok gelişen hastalarda ventilatör desteği ihtiyacının artabileceği, YBU ve hastanede kalma sürelerinin uzayabileceği ve mRS puanlarının artabileceği varsayıldı. Sonuç: Çalışma sonunda yapılan cerrahi girişimin türünün prognoza etkisinin olmadığı; buna karşılık düşük JOAS puanlarının, spinal şok gelişmesinin, ventilatör desteği verilmesinin, uzun süre yoğun bakım ünitesinde kalmanın hastaların prognozunu kötü etkileyebileceği öngörüldü.
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    Öğe
    Diffuse idiopathic skeletal hyperostosis (DISH): a clinical study
    (2019) Öğden, Mustafa; Yüksel, Ulaş; Akkaya, Süleyman; Oppong, Jonathan; Kısa, Üçler; Bakar, Bülent; Özveren, Mehmet Faik
    Aim: Diffuse idiopathic skeletal hyperosteosis (DISH) characterized by formation of disseminated osteofites on vertebra in the absence of traumatic or post infectious changes is a chronic disease of unknown etiology. This study was aimed to investigate the biochemical relationship of DISH in patients with DISH.Material and Method: Eleven patients diagnosed with DISH (DIH group) and eleven patients with axial pain but without any vertebral disease (Control group) who applied to the neurosurgery clinic between the years 2016-2017 were enrolled in this retrospective study. HLA-B27 antigen positivity, erythrocyte sedimentation rate, leukocyte, basofil and eosinophil counts, C-reactive protein, phosphorus and calcium levels, and their results in individuals were investigated. Anteroposterior and lateral pelvis, knee, lateral foot radiograms showing extra-axial involvement were viewed.Results: Of the patients with DISH, one owing to difficulty in swallowing and another owing to quadriplegia as a result of cervical trauma underwent surgical therapy. Radiological investigations of this group revealed iliac involvement in four patients and patellar joint involvement in one patient. There was no difference between groups with respect to age, sex, leucocyte, basophil and eosinophil count, C-reactive protein, phosphorus and calcium levels. However there was a significant difference with respect to dysphagia and extra-axial involvement. No individual was positive for HLA-B27 antigen.Conclusion: Present study findings suggested that both acute and/ or chronic inflammatory processes have no place in the etiology of this disease.
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    Öğe
    ECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS
    (2020) Yüksel, Ulaş; Öğden, Mustafa; Akkaya, Süleyman; Kısa, Üçler; Bakar, Bülent; Özveren, Mehmet Faik
    Objective: In this study, the economic cost, diagnostic andprognostic laboratory markers of lumbar spondylodiscitis, whichemerged as a complication after surgical intervention in thelumbar region, were investigated.Material and Methods: Age and gender of the patients wererecorded. Furthermore, surgical intervention type (spinalinstrumentation, lumbar discectomy), biopsy results of infectedtissue, concomitant morbidities, duration of hospital stay andmicroorganism growth in culture materials were evaluated inpatients. In addition, values of serum C-reactive protein (CRP)level, erythrocyte sedimentation rate (ESR), leukocyte, neutrophiland lymphocyte count which were obtained from these patients atadmission to hospital and at discharge from hospital wererecorded. Moreover, treatment costs of these patients wereexamined.Results: Nine patients (women=7, men=2) with a mean age of58±14.92 years were included in this study. All parameters ofpatients were not different in terms of surgical intervention type.However, when the patients were discharged from the hospital,their ESR and neutrophil counts decreased and lymphocyte countincreased in all of them. Although CRP level values decreased asnumerical value at discharge, this decrease was not statisticallysignificant. Correlation analysis showed that length of hospitalstay and tissue biopsy performed to the patients increased theeconomic cost.Conclusion: It was concluded that any routine laboratoryparameter investigated in this study could not be a validbiomarker for diagnosis and follow-up of spondylodiscitis thatemerged after surgical intervention. On the other hand, it wasconcluded that diagnosis and treatment of this disease, whoseprevalence is increasing, may have a high economic cost forpatients and countries.
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    Öğe
    Possible predictive markers to make a decision for surgical intervention in discography
    (2019) Öğden, Mustafa; Yüksel, Ulaş; Akkaya, Süleyman; Bulut, İbrahim Umut; Bakar, Bülent; Özveren, Mehmet Faik
    Aim: In this retrospective study, the diagnostic and therapeutic events of discography and disc-blockage (discoblock) were investigated in patients whose clinical symptoms could not be explained by CT and/or MR images.Material and Methods: The study included patients applied with discography between August 2014 and October 2016. Patient data were recorded, consisting of age, gender, pre-procedure Visual Analogue Scale (VAS) score (PRE-VAS), post-procedure VAS score (POST-VAS), and pre-procedure “Japanese Orthopedic Association” (JOA) score (PRE-JOA), post-procedure JOA score (POST-JOA), long-term follow-up VAS score (FOLLOW-VAS) and JOA score (FOLLOW-JOA), level of herniated disc in the spinal column (L1-2, L2-3, L3-4, L4-5, L5-S1), size of herniated disc (\"bulging\", \"protrusion\", \"extrusion\") and localization of the herniated disc in the spinal canal (median or foraminal).Results: Evaluation was made of a total of 22 patients (11 females, 11 males) aged 32 - 60 years. Discectomy after discography and/or discoblock was applied to 12 patients. The PRE-VAS scores of patients who underwent discectomy were higher than those of patients who did not undergo surgery, and the scores were lower in the postoperative period than those of the unoperated group. The long term (6 months) follow-up results indicated that patients with discectomy and those without surgery had similar levels of pain. The JOA scores of patients with discectomy were higher than those of patients without surgery. Conclusion: At the end of this study, it was thought that discography and discoblock procedure could be an adjunctive test for decision-making in respect of surgery for patients who were not diagnosed using radiological views and clinical symptoms. Furthermore, it was considered that the VAS score applied before and after discography may identify the patients who will be applied with discectomy.
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    Potential Risk Factors in Development of the “Halo Sign” in Patients Performed Transpedicular Screw Fixation Through the Posterior Spinal Approach
    (2020) Öğden, Mustafa; Yüksel, Ulaş; Akkurt, İbrahim; Dağlı, Ahmet Turan; Bakar, Bülent; Özveren, Mehmet Faik
    It has been shown in literature that a fibrous tissue called \"halo sign\" in the radiological terminology can develop aroundthe transpedicular screws implanted incompletely and/or incorrectly, which appears after movement of the screw in the cancellousbone. In this retrospective clinical study, 141 patients who underwent posterior spinal instrumentation for thoracic, lumbar orthoracolumbar vertebrae were evaluated using computed tomography (CT) and direct X-rays images for \"halo sign\" formationwhich refers in probable failure of spinal instrumentation. Hospital records included in the year 2014-2018 were examined and adultpatients who were performed lumbar, thoracal, and thoracolumbar spinal instrumentation via posterior approach due to reasons suchas \"spine fracture\", \"spondylosis\", \"spondylolisthesis\" and \"intervertebral disc hernia\" were included and evaluated in this study.The age and sex of the patients were recorded. Spinal X-ray and spinal CT images obtained during the postoperative follow-upperiod were examined. Halo sign was seen in 13 patients. Age (p=0.013), number of instrumented vertebrae (p=0.001) and numberof transpedicular screws (p<0.001) values were different between the patients with halo sign and patients without halo sign. As aresult, it was observed in this study that the formation of the halo sign in posterior spinal instrumentation system could develop inproportion to the number of transpedicular screw and patients' age. It was thought that the halo sign formation was not connectedwith the parameters called performed laminectomy, gender, inserted intervertebral cage, or vertebral region which were insertedtranspedicular screws.
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    Öğe
    PROGESTERONE INCREASES THE ISCHEMIC DAMAGE IN MALE RATS WITH CEREBRAL ISCHEMIA REPERFUSION INJURY
    (2019) Öğden, Mustafa; Bakar, Bülent; Altunkaya, Canan; Dağlı, Ahmet Turan; Özdemir, Alemiddin; Özveren, Mehmet Faik
    Objective: In the current literature, there are few acceptedpharmacological treatment methods for acute ischemic stroke.This study was conducted to investigate the effects ofprogesterone on transient ischemia / reperfusion injury in malerats.Material and Methods: A total of 25 Wistar albino male andyoung rats were divided into 5 groups called Control group,acute stage groups (Sham-A and PRG-A), and chronic stagegroups (Sham-C and PRG-C), randomly and their internalcarotid arteries were compressed using temporary aneurysmclips for 30 minutes. At 4 hours after removal of the clips,progesterone was injected to the animals of the PRG-A andPRG-C group via intraperitoneal route. After sacrifice of allanimals, pyknotic and necrotic neuronal cells were counted inhippocampal cornu amnonis (CA)1, CA2, CA3 and parietalcortical regions, histopathologically. Tissue interleukin (IL)-6,IL-10, caspase-3, and hypoxia-inducible factor-1 (HIF1) geneexpression levels were evaluated using real time polymerasechain reaction assay.Results: Histopathological and biochemical findings revealedthat progesterone has no healing effects on ischaemic neuronaltissue damage in either acute or chronic period. Moreover,progesterone was found to significantly increase symptoms ofischaemia in both acute and chronic periods compared tohealthy control group and even compared to Sham groups whereI/R injury was applied and no experimental agent wasadministered.Conclusion: At the end of this study, it was thought thatprogesterone had no therapeutic effect on cerebral ischemia /reperfusion injury in male sex rats and it could lead to increase itfurther, unfortunately.
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    Öğe
    SERVİKAL LAMİNEKTOMİ SONRASI EPİDURAL HEMATOM VE LHERMİTTE BULGUSU: OLGU SUNUMU
    (2019) Öğden, Mustafa; Akkaya, Süleyman; Özdemir, Alemiddin; Özveren, Mehmet Faik
    Boyun fleksiyonu ile ekstremitelere ve gövdeye yayılanelektriklenme hissi Lhermitte bulgusu olarak tanımlanmaktadırve spinal kordun servikal bölgede etkilenmiş olabileceğinidüşündürmektedir. Altmış dokuz yaşında erkek hastaya servikalspinal stenoz ve myelopati nedeniyle yapılan C3-4-5 unilateralhemilaminektomi bilateral dekompresyon sonrası 12. saattehastanı kollara ve bacaklara yayılan elektriklenme hissitariflemesi üzerine yapılan servikal manyetik rezonansgörüntülemesinde operasyon bölgesinde hematom görülmesiüzerine tekrar operasyona alındı. Hematom boşaltılmasını takibenbu bulgu kayboldu. Lhermitte bulgusunun görüldüğü klinikdurumlar çok çeşitli olabilmektedir. Servikal kordun posteriorkısımlarındaki demiyelinizasyon sonucu ortaya çıktığı düşünülür.Sensitif bir bulgu olmamasına rağmen servikal kompresifmyelopati için spesifitesi yüksektir. Operasyon sonrası Lhermittebulgusunun görülmesi kord kompresyonuna işaretedebileceğinden dikkatli olunmalı ve ileri tetkiklerdüşünülmelidir.
  • Küçük Resim
    Öğe
    Servikal Miyelopatili Hastalarda Unilateral Yaklaşım İle Bilateral Dekompresyonun Klinik Sonuçları
    (2018) Öğden, Mustafa; Akkaya, Süleyman; Yüksel, Ulaş; Daglı, Ahmet Turan; Bakar, Bülent; Özveren, Mehmet Faik
    Amaç: Servikal omurgadaki kemik ve ligamentöz yapıların dejeneratif değişiklikleri spinal kanal darlığına ve spinal kord basısına yol açmaktadır. Posterior destek sağlayan kas, ligament gibi yapıların korunarak, unilateral yaklaşım ile bilateral dekompresyon (UYBD) giderek yaygın olarak uygulanmaktadır. Bu çalışmada, unilateral yaklaşım ile bilateral dekompresyon cerrahi tekniği kullanılarak tedavi edilen servikal spondilotik myelopatili (SSM) hastalarda, bu yöntemin etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: SSM tanısıyla unilateral yaklaşım ile bilateral dekompresyon tekniği ile opere edilen hastaların verileri retrospektif olarak incelendi. Hastaların yaş, cinsiyet, operasyon öncesi ve 1 yıl sonrası ağrı şiddetini gösteren vizüel analog skala (VAS) değerleri ile OSWESTRY Disabilite İndeksi (ODİ) değerleri kayıt edildi. Bulgular: Çalışmamıza yaşları 41 ile 77 arasında değişen (ortalama 60.23±9.5 yıl) toplam 13 hasta dahil edildi. Hastaların %76.9’u erkek idi. Tedavi sonrası VAS ve ODİ değerleri karşılaştırıldığında tedavi sonrası değerlerde istatistiksel olarak anlamlı bir iyileşme görüldü (p=0.001). Sonuç: Çalışmamızda SSM’li hastalarda unilateral yaklaşım ile bilateral dekompresyon cerrahisiyle başarılı sonuçlar elde edilmiştir. SSM’li hastalarda henüz az sayıda çalışmada unilateral yaklaşım ile bilateral dekompresyon tekniği ile tedavinin etkinliği değerlendirilmiş olduğu dikkate alındığında, bu çalışmada elde ettiğimiz sonuçlar bundan sonraki çalışmalara ışık tutacaktır.