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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/6

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Now showing 1 - 4 of 4
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    PublicationOpen Access
    Disc rehydration after dynamic stabilization: a report of 59 cases
    (Korean Spine Society, 2017) Yılmaz, Atilla; Yıldırım, Hakan; N/A; Şentürk, Salim; Sasani, Mehdi; Öktenoğlu, Bekir Tunç; Yaman, Onur; Süzer, Süleyman Tuncer; Özer, Ali Fahir; Doctor; Faculty Member; Doctor; Faculty Member; School of Medicine; N/A; N/A; N/A; N/A; 221691; 1022
    Study Design: A retrospective study investigating decrease in the nucleus pulposus signal intensity or disc height on magnetic resonance imaging (MRI) and disc degeneration. Purpose: Although a degenerated disc cannot self- regenerate, distraction or stabilization may provide suitable conditions for rehydration and possible regeneration. This study aimed to evaluate clinical outcomes and disc regeneration via MRI in a series of patients with degenerative disc disease (DDD) who underwent lumbar stabilization with a dynamic stabilization system (DSS). Overview of Literature: A dynamic system provides rehydration during early DDD. Methods: Fifty- nine patients (mean age, 46.5 years) who undedwent stabilization with DSS for segmental instability (painful black disc) between 2004 and 2014 were retrospectively evaluated. All patients underwent MRI preoperatively and 12 months postoperatively. Intervertebral disc (IVD) degeneration grades at the implanted segment were categorized using the Pfirrmann classification system. Patients were followed for a mean of 6.4 years, and clinical outcomes were based on visual analog scale (VAS) and Oswestry disability index (ODI) scores. Results: Significant improvements in back pain VAS and ODI scores from before surgery (7 and 68%, respectively) were reported at 6 (2.85 and 27.4%, respectively) and 12 months postoperatively (1.8 and 16.3%, respectively). Postoperative IVD changes were observed in 28 patients. Improvement was observed in 20 patients (34%), whereas progressive degeneration was observed in eight patients (13.5%). Thirty- one patients (52.5%) exhibited neither improvement nor progression. Single Pfirrmann grade improvements were observed in 29% of the patients and two- grade improvements were observed in 5%. Conclusions: Our observations support the theory that physiological movement and a balanced load distribution are necessary for disc regeneration. We conclude that DSS may decelerate the degeneration process and appears to facilitate regeneration.
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    PublicationOpen Access
    Ultrasound-guided intralesional methylene blue injection for the arthroscopic decompression of spinoglenoid notch cyst causing suprascapular neuropathy
    (Elsevier, 2020) Altıntaş, Burak; Koyuncu, Özgür; Fox, Michael; Büyükdoğan, Kadir; Eren, İlker; Birsel, Olgar; Demirhan, Mehmet; Doctor; Faculty Member; School of Medicine; Koç University Hospital; N/A; 168021; N/A; 9882
    Symptomatic spinoglenoid ganglion cyst is a rare cause of shoulder pain and disability. Surgical treatment, which may be considered after failed nonoperative treatment, includes open or arthroscopic cyst debridement. Arthroscopic treatment is less invasive and has the advantage of addressing intraarticular pathologies; however, exposure of the cyst may be deemed difficult. Furthermore, the suprascapular nerve is susceptible to iatrogenic injury owing to its close proximity to the posterior glenoid rim. The purpose of this article is to present our technique for arthroscopic spinoglenoid cyst decompression after preoperative ultrasound-guided methylene blue injection.
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    PublicationOpen Access
    Biomechanical study on three screw-based atlantoaxial fixation techniques: a finite element study
    (Korean Spine Society, 2022) Erbulut, D.U.; Mumtaz, M.; Zafarparandeh, I.; Özer, Ali Fahir; Faculty Member; School of Medicine; 1022
    Study design: this is a finite element study. Purpose: This study is aimed to compare the biomechanical behaviors of three screw-based atlantoaxial fixation techniques. Overview of literature: Screw-based constructs that are widely used to stabilize the atlantoaxial joint come with their own challenges in surgery. Clinical and in vitro studies have compared the effectiveness of screw-based constructs in joint fixation. Nevertheless, there is limited information regarding the biomechanical behavior of these constructs, such as the stresses and strains they experience. Methods: a finite element model of the upper cervical spine was developed. A type II dens fracture was induced in the intact model to produce the injured model. The following three constructs were simulated on the intact and injured models: transarticular screw (C1- C2TA), lateral mass screw in C1 and pedicle screw in C2 (C1LM1-C2PD), and lateral mass screw in C1 and translaminar screw in C2 (C1LM1-C2TL). Results: in the intact model, flexion-extension range of motion (ROM) was reduced by up to 99% with C11-C2TA and 98% with C1LM1-C2PD and C1LM1-C2TL. The lateral bending ROM in the intact model was reduced by 100%, 95%, and 75% with C11-C2TA, C1LM1-C2PD, and C1LM1-C2TL, respectively. The axial rotation ROM in the intact model was reduced by 99%, 98%, and 99% with C11-C2TA, C1LM1-C2PD, and C1LM1-C2TL, respectively. The largest maximum von Mises stress was predicted for C1LM1-C2TL (332 MPa) followed by C1LM1-C2PD (307 MPa) and C11-C2TA (133 MPa). Maximum stress was predicted to be at the lateral mass screw head of the C1LM1-C2TL construct. Conclusions: our model indicates that the biomechanical stability of the atlantoaxial joint in lateral bending with translaminar screws is not as reliable as that with transarticular and pedicle screws. Translaminar screws experience large stresses that may lead to failure of the construct before the required bony fusion occurs.
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    PublicationOpen Access
    Editorial commentary: anatomic or not, the tunnel will get wider!
    (Elsevier, 2020) Mermerkaya, Musa Uğur; Hakyemez, Ömer Serdar; Birinci, Murat; Avcı, Cem Coşkun; Büyükdoğan, Kadir; Doctor; School of Medicine
    In our experience, arthroscopic tunnel widening is one of the major complications after anterior cruciate ligament (ACL) reconstruction. Even though this complication doesn't require an acute correction or intervention, patients with failed ACL reconstruction along with tunnel widening may need a 2-stage revision in which we have to fill the gap in the tunnels first. Otherwise, this tunnel widening after ACL reconstruction doesn't affect the clinical outcomes of the primary surgery and it won't affect the success of the surgery in the aspects of clinical and functional outcomes.