Researcher:
Başak, Ahmet Tulgar

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Doctor

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Ahmet Tulgar

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Başak

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Başak, Ahmet Tulgar

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2021 - 20223

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Researcher Of Publications: search.filters.isAuthorOfPublication.8c15428e-4872-4754-b177-7d38798f9a1d

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    Lumbar dynamic stabilization with 2-stage surgery: early results
    (Elsevier, 2022) HekimoǧLu, Mehdi Akgül, Turgut Özbek, Muhammet Arif; Özer, Ali Fahir; Ateş, Özkan; Sasani, Mehdi; Öktenoğlu, Bekir Tunç; Günerbüyük, Caner; Aydın, Ahmet Levent; Başak, Ahmet Tulgar; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Teaching Faculty; Doctor; Doctor; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; School of Medicine; 1022; 118533; 219451; 220898; 380939; N/A; N/A
    Background: Screw loosening, which is a major problem in dynamic systems, can be easily overcome with 2-stage surgery. In this article, the clinical and radiological results of patients undergoing dynamic stabilization with a Dynesys device in 2 stages are discussed. Methods: A total of 10 male and 13 female adult patients were included in this single-center retrospective study conducted between 2018 and 2021. The mean age of the patients was 65.6 years. All of the patients had pain complaints that affected their daily lives. Bone density T scores were determined with the dual-energy x-ray absorptiometry method before patients were admitted for surgery. In the first surgery, Dynesys system pedicle screws were inserted. After 6 months of osteointegration, Dynesys system spacers and elastic bandages were placed. Preoperative, early postoperative, and late postoperative visual analog pain scale (VAS) scores and Oswestry Disability Index (ODI) scores were determined and statistically compared. Results: Patients were followed for an average of 30 months. Complications and recurrence were not observed. Neurological deficits were not observed after patients recovered from anesthesia. Significant improvement was observed in the ODI and VAS parameters in the preoperative (ODI: 66.2%, VAS: 7.8), early postoperative (ODI: 20.3%, VAS: 2.4), and late postoperative (ODI: 6.8% and VAS: 1.1) periods. Symptomatic improvement was seen in all patients. No screw breakage or loosening was detected by radiological evaluation in any of the patients during the 2-year follow-up period. Conclusions: In our experience, the insufficiency of the proximal and distal end screws is eliminated when 2 stages of dynamic system stabilizations are completed after osteointegration of the screws.
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    The endoscopic trans-sinusoidal trans-pterygopalatine route to the foramen rotundum approach in trigeminal neuralgia treatment
    (Turkish Neurosurgical Soc, 2022) Özbek, Muhammet Arif; Çakıcı, Nazlı; Şakul, Bayram Ufuk; Akalan, Nejat; N/A; Başak, Ahmet Tulgar; Doctor; Koç University Hospital; N/A
    AIM: To describe a new, minimally invasive, and safe access to foramen rotundum via the endoscopic endonasal trans-sinusoidal route for trigeminal nerve blockage. MATERIAL and METHODS: We studied 5 fresh cadavers bilaterally, and 10 pterygopalatine fossae and maxillary nerves using the endoscopic endonasal trans-sinusoidal trans-pterygopalatine approach. RESULTS: The proposed approach enabled the maxillary nerve to be visualized after revealing the foramen rotundum with the help of some craniometric measurements. Distance between sphenoid sinus lateral wall and maxillary sinus posterior wall was measured. This measurement was found to be an important triangulation point to determine the location of the entrance to the pterygopalatine fossa. The distance between the foramen rotundum and the sphenopalatine artery was found to be significant. The foramen rotundum diameter was calculated, and the maxillary nerve was found to be situated inferolateral to the foramen rotundum. Therefore, the safe entry zone was determined superomedially. No significant difference was found between male and female and the right and left nostrils. CONCLUSION: Various surgical procedures have been applied to treat drug-resistant trigeminal neuralgia. Nevertheless, their cure rates remain less than anticipated. Recurrences up to 30% have been reported in the literature. In this study, the endoscopic endonasal transmaxillary trans-pterygopalatine route offers a new perspective on the foramen rotundum approach and provides a panoramic and safe view in previously high-risk percutaneous interventions.
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    Chitosan channels stuffed with mesenchyme originated stem/progenitor cells for renovate axonal regeneration in complete spinal cord transection
    (Turkish Neurosurgical Society, 2021) Çakıcı, Nazlı; Bozkurt, Gökhan; Puralı, Nuhan; Denkbaş, Emir Baki; Korkusuz, Petek; Uçkan Çetinkaya, Duygu; Başak, Ahmet Tulgar; Doctor; Koç University Hospital
    Aim: to examine the implantation of chitosan channels stuffed with mesenchyme-originated stem/progenitor cells (MSPCs) derived from adult rats in a spinal cord transection model. The level of axonal regeneration, the effect of chitosan channels on the survival of MSPCs, and the functional recovery results were also evaluated. Material and methods: chitosan channels stuffed with MSPCs were implanted at the level of T8 in a transected rat spinal cord. MSPCs were harvested from the pelvic bone marrow of adult rats, and the MSPC-chitosan channel group was compared with three control groups. The axonal regeneration capacity, the effect of chitosan channels on the survival of MSPCs, and the functional recovery results were compared among four groups. The survival of MSPCs was evaluated using histopathological techniques and electron microscopy, axonal regeneration/germination was evaluated by confocal microscopy, and locomotor function was assessed for 4 weeks using the Basso, Beattie, and Bresnahan locomotor score. Results: the MSPC-chitosan channel group exhibited enhanced survival of transplanted MSPCs compared with MSPCs transplanted directly into the lesion cavity, although no significant difference was detected in locomotor function between the treatment and control groups. The MSPC-chitosan channel group demonstrated thicker myelination of axons than the other groups. Conclusion: chitosan channels promoted the survival of transplanted MSPCs and created a tissue bridge after complete spinal cord transection. They also induced axonal regeneration and germination. No significant improvement in functional recovery was found between the groups.