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    Analysis of biochemical laboratory values to determine etiology and prognosis in patients with subarachnoid hemorrhage: a clinical study
    (Taylor & Francis Ltd, 2019) Ogden, Mustafa; Bakar, Bulent; Karagedik, Mustafa Ilker; Bulut, Ibrahim Umud; Cetin, Cansel; Aydin, Gulcin; Ozveren, Mehmet Faik
    Objectives: The aim of this study was to establish prognostic and predictive markers in patients with subarachnoid hemorrhage (SAH) using simple laboratory methods. Methods: A retrospective examination was made of patients with SAH diagnosed secondary to isolated head trauma, isolated anterior communicating artery aneurysm rupture, and angiography-negative SAH. Age, gender, Glasgow Coma Scale (GCS) scores, and Fisher's grade scores, Glasgow Outcome Scale (GOS) scores, leukocyte count, neutrophil count, lymphocyte count, platelet count, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio results (PLR) were evaluated. Results: NLR and PLR values, which were similar in patients with spontaneous SAH, were significantly high in patients with traumatic SAH. NLR and PLR values could be 80% sensitive and 75% specific for distinguishing traumatic SAH from spontaneous SAH. Eosinophil count was lower in patients with angiography-negative SAH and patients with aneurysmal SAH than in patients with traumatic SAH. Initially measured GCS score, Fisher's grade score, eosinophil, neutrophil and lymphocyte counts could be prognostic in all patients with SAH. Moreover, it was concluded that the initially measured number of eosinophils might be directly related to patient prognosis. The eosinophil count was generally found to be high in traumatic SAM patients and it was observed that this parameter could be predictive for these patients. Lymphocyte count and NLR values could be prognostic markers in patients with angiography-negative SAH. Conclusion: NLR, PLR and eosinophil count values could be predictive for etiological factors (traumatic SAH or spontaneous SAH) of patients who were admitted unconscious to the emergency room with SAH detected on radiological imaging.
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    Analysis of radiological measurement parameters that can predict the type of treatment to be applied in odontoid fractures: Clinical research
    (Wolters Kluwer Medknow Publications, 2023) Ogden, Mustafa; Erdogan, Ahmet Melih; Karagedik, Mustafa Ilker; Baser, Selcuk; Bulut, Ibrahim Umud; Sevimoglu, Ozge; Yuksel, Ulas
    Introduction: Although various conservative and surgical treatment methods have been proposed, treatment options for patients with odontoid fractures remain controversial. This study was conducted to determine some demographic and radiological measurement parameters that can predict treatment options in patients with odontoid fractures. Materials and Methods: The patients were separated into the surgery (-) group (n = 9) and the surgery (+) group (n = 10). Patient data were recorded of age, gender, type of odontoid fracture, morphological measurement results obtained from computed tomography images, treatment regimens, duration of stay in the hospital, and mortality rate. In the operating room, a halo-vest corset or Philadelphia-type cervical collar was applied to the surgery (-) patients after the reduction of the fracture under fluoroscopy. Anterior odontoid lag screw fixation was performed on surgery (+) patients. Results: The amount of displacement of the fractured odontoid, the distance between the C1 vertebra and the odontoid process, the angle between the posterior wall of the odontoid process and the posterior wall of the clivus, the slip angle, and the anterior to posterior width of the spinal canal were not different between the groups. No difference was determined between the groups in respect of the amount of lateral displacement of the odontoid process in the spinal canal in the axial plane and the angle of the fractured odontoid process with the C2 vertebral body. Conclusion: This preliminary study showed that the demographic data and radiological measurement parameters analyzed in the present study could not be used as predictive markers either in decision-making for treatment modality or mortality risk.
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    Clinical and Laboratory Markers in Determination of Treatment Modalities and Short-Term Prognosis in Patients with Traumatic Acute Subdural Hematoma: Original Study
    (Georg Thieme Verlag Kg, 2023) Bakar, Bulent; Yuksel, Ulas; Ozdemir, Alemiddin; Bulut, Ibrahim Umud; Ogden, Mustafa
    Objective In patients with traumatic acute subdural hematoma (ASH), it has not been yet fully elucidated which patients can benefit from surgery or from clinical follow-up. This study was constructed to predict treatment modality and short-term prognosis in patients with ASH using their clinical, radiological, and biochemical laboratory findings during admission to hospital. Methods Findings of patients with ASH determined on their CT scan between 2015 and 2018 were evaluated. Patients were grouped in terms of ASH-FOL (patients followed-up without surgery, n =13), ASH-OP (patients treated surgically, n =10), and ASH-INOP (patients considered as inoperable, n = 5) groups. They also were divided into survived (n = 14) and nonsurvived (n = 14) groups. Results ASH developed as a result of fall from a height in 15 patients and traffic accidents in 13 patients. In deciding for surgery, it was determined that Glasgow coma scale (GCS) scores < 8, midline shift (MIS) level > 5 mm, MLS-hematoma thickness ratio > 0.22, leukocyte count > 12730 uL, and presence of anisocoria could be used as predictive markers. It was determined that GCS scores < 8, hematoma thickness value > 8 mm, and the presence of anisocoria could be considered as biomarkers in prediction of mortality likelihood. Conclusion It could be suggested that GCS scores, MLS level, MLS-hematoma thickness ratio, presence of anisocoria, and leukocyte count value could help in determination of the treatment modality in patients with ASH. Additionally, GCS scores, hematoma thickness value, and presence of anisocoria could each be used as a marker in the prediction of early-stage prognosis and mortality likelihood of these patients.
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    Investigation of the Efficacy of Bilateral Osteoligamentous Decompression via Hemilaminectomy in Cervical Spondylotic Myelopathy: A Clinical Study
    (Elsevier Science Inc, 2023) Ogden, Mustafa; Karagedik, Mustafa Ilker; Ozdemir, Alemiddin; Bulut, Ibrahim Umud; Erdogan, Ahmet Melih; Bakar, Bulent
    OBJECTIVE: Cervical stability may deteriorate and kyphotic spinal deformities may develop in cervical spondylotic myelopathy (CSM) after laminectomy or lam-inoplasty. This study aimed to investigate the therapeutic efficacy of the bilateral osteoligamentous decompression via unilateral hemilaminectomy approach (UHBOLD) technique in CSM patients.METHODS: The study included 34 adult patients who u nderwent UHBOLD surgery for CSM between 2016 and 2022. A record was made for all patients of age, gender, n umber of operated levels, preoperative and postoperative long-term follow-up VAS scores, Nurick grade values and mJOA scores, kyphosis angles measured on X-ray, and spinal canal areas measured on T2-weighted MR axial images.RESULTS: Preoperative VAS scores of the patients were 6 (4-9), Nurick grade values were 3 (2-5), mJOA scores were 10.50 +/- 3.42, kyphosis angles were-13.34 +/- 13.69(degrees) and spinal canal areas were 87.11 +/- 28.30 mm(2). In post-operative long-term follow-up of these patients, VAS scores were 2 (1-5), Nurick grade values were 1 (0-5), mJOA scores were 13.94 +/- 3.09, kyphosis angles were-15.07 +/- 12.78(degrees) and spinal canal areas were 149.65 +/- 42.57 mm(2). A statistically significant difference was determined between the preoperative and the post-operative long-term follow-up VAS scores, Nurick grade values, mJOA scores, and spinal canal areas (P < 0.001). Kyphosis angles were not different (P [ 0.198), and no instability was observed in any patient in long-term follow-u p.CONCLUSIONS: The UHBOLD technique performed in multilevel CSM patients did not cause any change in cer-vical lordosis angle in long-term follow-up, did not cause cervical kyphotic deformity or cervical instability, and significantly improved Nurick grade values, and VAS and mJOA scores.
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    Predictive Markers in Decision-Making for Screwing the Fractured Thoracolumbar Vertebra in the Short-Segment Instrumentation
    (Japanese Soc Spine Surgery & Related Research, 2022) Ogden, Mustafa; Yuksel, Ulas; Karagedik, Mustafa Ilker; Bulut, Ibrahim Umud; Bakar, Bulent
    Introduction: In this study, it is aimed to compare the long-term results of patients with short-segment instrumentation where screws were inserted into the fractured vertebra with those of patients with long-segment instrumentation applied by skipping the fractured vertebra and reveal the predictive markers in decision-making for screwing fractured vertebra.Methods: Patients were separated into two groups, namely, Group A (patients in which the fractured vertebra and vertebrae above and below the fractured vertebra were screwed (short-segment instrumentation, n=22) and Group B (patients in whom the fractured vertebra was not screwed, whereas two vertebrae above and below the fractured vertebra were screwedResults: The presence of pedicle fracture, AOSpine Classification Scale score, the height of the fractured vertebra, vertebra height below the fractured vertebra, spinal canal diameter, and duration of stay in hospital were different between the groups, preoperatively (p<0.05). Fractured vertebra height, vertebra height below the fractured vertebra, and Karnofsky Performance Scale score were different between the groups in long-term follow-up (p<0.05). The preoperative measurement values were similar to each group's postoperative long-term follow-up results. Logistic regression analysis revealed that the presence of pedicle fracture, AOSpine Classification Scale score, vertebra height below the fractured vertebra, and spinal canal diameter could be the best parameters in decision-making for screwing fractured vertebra (p<0.05). Conclusions: Both instrumentation procedures were observed to have similar effectiveness in preventing a collapse in fractured vertebra during long-term follow-up. It was thought that the AOSpine Classification Scale score, presence of pedicle fracture, vertebra height below the fractured vertebra, and spinal canal diameter could be used as predictive markers in decision-making for screwing fractured vertebrae. Consequently, it was concluded that patients with pedicle fractures, more height loss in the vertebra below the fractured vertebra, and narrow spinal canal would not be suitable for screwing the fractured vertebra.