Researcher:
Akgün, Mehmet Yiğit

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Doctor

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Mehmet Yiğit

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Akgün

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Akgün, Mehmet Yiğit

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2022 - 20236

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    Foraminoplasty with partial pediculectomy in degenerative spondylolisthesis cases with nerve compression
    (Elsevier Inc., 2023) Toklu, Sureyya; N/A; Akgün, Mehmet Yiğit; Günerbüyük, Caner; Ateş, Özkan; Aydın, Ahmet Levent; Baran, Oğuz; Öktenoğlu, Bekir Tunç; Sasani, Mehdi; Özer, Ali Fahir; Doctor; Teaching Faculty; Faculty Member; Doctor; Faculty Member; Faculty Member; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; 380939; 118533; N/A; 291138; 220898; 219451; 1022
    Background: Degenerative spondylolisthesis refers to a forward displacement of a vertebra relative to the underlying vertebra. Patients with radicular pain and/or neurogenic claudication are considered suitable candidates for surgical intervention. The aim of this study was to present clinical results of dynamic stabilization applied after pediculectomy and neural foramen enlargement in patients with degenerative spondylolisthesis and normal spinal sagittal balance. Materials and Methods: All patients who underwent pediculectomy and dynamic stabilization for lumbar degenerative spondylolisthesis were retrospectively identified. Diagnosis was made with detailed neurological and radiological imaging examinations for the anatomical location of the pain. Demographic data, visual analog scale scores, and quality-of-life scores were obtained. Results: Patients included 3 (33.3%) men and 6 (66.7%) women with a mean age of 61.3 ± 13.0 years (range, 46–80 years) at initial symptom onset. Grade 1 degenerative spondylolisthesis was present in 5 (55.6%) patients, and grade 2 was present in 4 (44.4%) patients. Pathology was detected in L4-5 in 4 patients (44.4%) and L5-S1 in 5 patients (55.6%). In all patients, at the 3-month follow-up, statistically significant decrease in visual analog scale and Oswestry Disability Index scores was observed. At the last follow-up, no implant-related complications requiring revision were observed. Conclusions: In patients without any pathology in the sagittal balance, the optimal physiological treatment modality can be created by applying posterior dynamic stabilization together with pediculectomy to support the posterior tension band. © 2023 Elsevier Inc.
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    Preoperative magnetic resonance imaging abnormalities predictive of lumbar herniation recurrence after surgical repair
    (Elsevier Science Inc, 2022) Karadag, Mehmet Kursat; Akinci, Ahmet Tolgay; Basak, Ahmet Tulgar; Hekimoglu, Mehdi; Yildirim, Hakan; Akyoldaş, Göktuğ; Aydın, Ahmet Levent; Ateş, Özkan; Öktenoğlu, Bekir Tunç; Sasani, Mehdi; Akgün, Mehmet Yiğit; Özer, Ali Fahir; Günerbüyük, Caner; Faculty Member; Doctor; Faculty Member; Faculty Member; Faculty Member; Doctor; Faculty Member; Teaching Faculty; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; Koç University Hospital; 203677; N/A; 118533; 220898; 219451; N/A; 1022; 380939
    Objective: There are currently no standard criteria for evaluating the risk of recurrent disk herniation after surgical repair. This study investigated the predictive values of 5 presurgical imaging parameters: paraspinal muscle quality, annular tear size, Modic changes, modified Phirrmann disk degeneration grade, and presence of sacralization or fusion. Methods: Between 2015 and 2018, 188 patients (89 female, 99 male, median age 50) receiving first corrective surgery for lumbar disk herniation were enrolled. Micro-diskectomy was performed in 161 of these patients, and endoscopic translaminar diskectomy approach was performed in 27 patients. Clinical status was evaluated before surgery and 4, 12, and 24 months post surgery using a visual analog scale, Oswestry Disability Index, and Short Form 36. Results: Recurrent disk herniation was observed in 21 of 188 patients. Seventeen of the recurrent disk herniations were seen in those who underwent microdiskectomy and 4 in those who underwent endoscopic translaminar diskectomy. There were significant differences in visual analog scale, Oswestry Disability Index, and Short Form 36 scores at 4, 12, and 24 months between patients with recurrence and the 167 no-recurrence patients. The median annular tear length was significantly greater in patients with recurrence than without recurrence. In addition, there were significant differences in recurrence rate according to Modic change type distribution, sacralization or fusion presence, Pfirmann disk; degeneration grade distribution, dichotomized annular tear size, dichotomized Modic change; and type and simplified 3-tier muscle degeneration classification distribution. Conclusions: Patients with poor clinical scores and recurrence exhibited additional radiologic abnormalities before surgery, such as poor paraspinal muscle quality, longer annular tears, higher Modic change type, higher modified Phirrmann disk degeneration grade, and sacralization or fusion. This risk evaluation protocol may prove valuable for patient selection, surgical planning, and choice of postoperative recovery regimen.
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    The effectiveness of bone scintigraphy in the management of low back pain
    (Elsevier, 2022) Akgün, Elife; N/A; Akgün, Mehmet Yiğit; Doctor; N/A; Koç University Hospital; N/A
    Background: Back and low back pain have been reported as one of the leading causes of activity restriction. While degenerative changes in the spine are among the common causes of low back pain, zygapophyseal (facet) joint pain is seen as the most widely accepted cause of back pain. Standard imaging modalities may have low pre-dictive value in detecting the source of back pain. Thanks to radionuclide bone scintigraphy, painful lesions can be distinguished from age-related changes, especially in patients with chronic low back pain. In this study, we aimed to retrospectively evaluate the clinical results of facet-induced low back pain, which was confirmed by bone scintigraphy, after facet injection treatment.Methods: We completed a retrospective review of patients who underwent diagnostic radionuclide bone scin-tigraphy imaging for low back pain at our institution from 2019 to 2021. Scintigraphy imaging was often per-formed in conjunction with traditional diagnostic imaging. The patients underwent injection at the levels that were decided by the referring physician on the basis of the clinical symptoms, the physical examination findings, and findings on existing radiologic images, with performance of bone scanning. Results: The patients consisted of 24 (47.1 %) males and 27 (52.9 %) females with a mean age of 44.03 +/- 9.26 years (range 34-67 years) at initial symptom onset. In the bone scintigraphy, increased radioactive uptake was detected in the facet joints of the lumbar region in 33 of 51 (64.7 %) patients. Statistically significant improvement was found in VAS-ODI and SF-36 scorings in 30 patients (90.1 %) after injection in patients with increased radioactive uptake. Statistically significant improvement was found in VAS-ODI and SF-36 scorings in 12 (66.6 %) patients who had no pathological findings with imaging modalities and were injected according to physical examination. When the two groups were compared with each other, the success rate in the group with increased radioactive uptake was found to be statistically significantly higher (p < 0.01)Conclusions: Application of this technology may lead to more reliable diagnosis and treatment of painful facet arthropathy. Appropriate diagnostic tests and determination of spinal level localization will provide satisfactory results with correct patient selection
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    Radiological and clinical follow-up of Alpha-D cervical disk prosthesis
    (Springer Heidelberg, 2023) Karadağ, Mehmet Kürşat; Başak, Ahmet Tulgar; Hekimoğlu, Mehdi; Erbulut, Deniz Ufuk; Öktenoğlu, Bekir Tunç; Günerbüyük, Caner; Akgün, Mehmet Yiğit; Aydın, Ahmet Levent; Özer, Ali Fahir; Faculty Member; Teaching Faculty; Doctor; Doctor; Faculty Member; School of Medicine; Koç University Hospital; 220898; 380939; N/A; N/A; 1022
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    Posterior-only approach in patients with poor general condition and spinal metastatic vertebral fracture
    (Neurocirugia, 2022) Ulu, Mustafa Onur; Alizada, Orkhan; Akcil, Eren Fatma; Kartum, Tufan Agah; Hanci, Murat; Akgün, Mehmet Yiğit; Doctor; N/A; Koç University Hospital; N/A
    Purpose: The surgical treatment of spinal metastases is mostly palliative in nature and focuses on improving the quality of life of patients. The posterior transpedicular surgical approach provides circumferential 360° decompression, allows reconstruction and stabilisation to be achieved in a single session and can be performed using an open, mini-open or minimally invasive approach. We present and discuss the surgical techniques and outcomes for patients with single-level metastatic spinal disease and in poor general condition who underwent surgery via the posterior-only transpedicular corpectomy approach and reconstruction with expandable corpectomy cages. Methods: Patients with a single level thoracolumbar metastatic disease (T3-L5) and a Karnofsky score of ≤70, who underwent a complete posterior transpedicular corpectomy with expandable cage reconstruction of the anterior spinal column were retrospectively reviewed. Patients’ demographics, SINS, modified Tokuhashi scores as well as preoperative and postoperative ASIA scale, Karnofsky scores, VAS scores and vertebral height/Cobb angle values were analysed. Results: A total of 44 patients (24 M/20 F) (mean age 53.25 ± 21.26 years) met the inclusion criteria. The modified Tokuhashi scores were as follows: score 0–8, 5 (11.4%) patients; score 9–11, 14 (31.8%) patients; and score 12–15, 25 (56.8%) patients. There were significant improvements in the postoperative VAS scores (mean 7.7–2.9), Karnofsky scores (mean 63.3–79.6) as well as the Cobb angles (18.6–12.8°) and vertebral height. Thirtyfive patients showed improved neurological function by at least one ASIA grade, whereas 9 showed no improvement during the postoperative period. Conclusions: This technique, which has a low complication rate and a short recovery time, can help achieve satisfactory results even in patients with poor metabolic profiles and Karnofsky scores in the preoperative period. Further clinical studies with large patient groups are warranted to confirm the results of this study. © 2022 Sociedad Española de Neurocirugía
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    Effect of radiofrequency denervation on pain severity among patients with cervical, thoracic or lumbar spinal pain: a clinical retrospective study
    (Elsevier, 2022) Akgül, Mehmet Hüseyin; Akgün, Mehmet Yiğit; Doctor; Koç University Hospital
    Background: low back pain is the leading cause of job-related disabilities. The zygapophyseal (facet) joint has been identified as a cause of spinal pain in 15%-45% of individuals. Radiofrequency ablation (RFA) to the facet joints of the lumbar, cervical and thoracic regions and discussion of the 2-year follow-up results will provide additional data and contribute to understanding the long-term effectiveness of RFA. Methods: patients with cervical, thoracic or low back pain, not accompanied by radicular pain and without pri-mary and/or metastatic disease in the spinal region during radiological evaluation were retrospectively analysed. A total of 1274 patients aged >18 years who had clinical follow-up for at least 1 year and had back pain for >6 months were included in the study. The RFA groups were compared within themselves before and after the application. Moreover, patients who received RFA were compared with those who did not receive RFA (controls). The visual analogue scale and quality-of-life scores of the patients were evaluated. Periodic clinical follow-ups revealed changes in neurological status. Results: of the 774 patients who underwent RFA, 156, 184 and 434 patients had pain in the cervical, thoracic and lumbar and lumbosacral regions, respectively. The control groups consisted of 108, 122 and 270 patients, respectively. No significant difference in any of the baseline demographic variables was observed between the groups (p > 0.05). A significant improvement was found in both visual analogue scale and quality-of-life scores when compared before and after RFA application within the groups. In addition, a significant improvement was found in the RFA group compared with the control group.Conclusions: as far as we know, this is the first comparative study of RFA involving the cervical, thoracic and lumbar spinal regions. RFA made it possible to obtain satisfactory results in all three regions. With its increasing popularity and frequency of use, new indications for RFA may emerge.