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  • Küçük Resim
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    An evaluation of the quality of sleep before and after surgical treatment of patients with cervical disc herniation
    (Korean Neurosurgical Society, 2018) Öğden, Mustafa; Akgül, Mehmet Hüseyin; Yüksel, Ulaş; Bakar, Bülent; Kamaşak, Kağan; Özveren, Mehmet Faik
    Objective: It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment. Methods: The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively. Results: The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points. Conclusion: The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength. © 2018 The Korean Neurosurgical Society.
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    Öğe
    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 around the transpedicular screws implanted incompletely and/or incorrectly, which appears after movement of the screw in the cancellous bone. In this retrospective clinical study, 141 patients who underwent posterior spinal instrumentation for thoracic, lumbar or thoracolumbar vertebrae were evaluated using computed tomography (CT) and direct X-rays images for "halo sign" formation which refers in probable failure of spinal instrumentation. Hospital records included in the year 2014-2018 were examined and adult patients who were performed lumbar, thoracal, and thoracolumbar spinal instrumentation via posterior approach due to reasons such as "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-up period were examined. Halo sign was seen in 13 patients. Age (p=0.013), number of instrumented vertebrae (p=0.001) and number of transpedicular screws (p<0.001) values were different between the patients with halo sign and patients without halo sign. As a result, it was observed in this study that the formation of the halo sign in posterior spinal instrumentation system could develop in proportion to the number of transpedicular screw and patients' age. It was thought that the halo sign formation was not connected with the parameters called performed laminectomy, gender, inserted intervertebral cage, or vertebral region which were inserted transpedicular screws.
  • [ X ]
    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.
  • Küçük Resim
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    The effects of microdecompression on patients with lumbar degenerative spinal stenosis with or without degenerative spondylolisthesis
    (Turkish Neurosurgical Society, 2019) Öğden, Mustafa; Yüksel, Ulaş; Bakar, Bülent; Akkaya, Süleyman; Kamaşak, Kağan; Dağlı, Ahmet Turan
    AIM: To investigate the mid-term efficacy of bilateral decompression with a unilateral approach (BDUA) on symptoms and quality of life of in patients with lumbar spinal stenosis (LSS), with low grade (with percentage slip < 25%) degenerative spondylolisthesis or without spondylolisthesis. MATERIAL and METHODS: The study included patients who underwent BDUA due to one or two-level LSS related to degenerative spondylosis and/ or degenerative spondylolisthesis. Pre- and postoperative data of the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), and walking distance were compared. RESULTS: Evaluation was made up of a total of 53 patients, comprising 32 males and 21 females with a mean age of 60.6 ± 9.0 years. Compared with the preoperative data, VAS, ODI and walking distance improved significantly in all patients at the 3-year follow-up examination. Furthermore, a significant improvement was determined in the clinical parameters of patients with degenerative spondylolisthesis, with no worsening of slip and no requirement for instrumentation. Moreover, when patients were separated into two groups according to age, as elderly (>60 years) and adult (<60 years), similar improvements were seen in both groups. CONCLUSION: BDUA could be quite effective in reducing pain, improving quality of life and walking distance with no worsening of the grade or degree of slipping. © 2019, Turkish Neurosurgical Society.
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    Öğe
    The Effects of Microdecompression on Patients with Lumbar Degenerative Spinal Stenosis with or without Degenerative Spondylolisthesis
    (2019) Öğden, Mustafa; Yüksel, Ulaş; Akkaya, Süleyman; Kamaşak, Kağan; Daglı, Ahmet Turan; Bakar, Bülent
    AIM: To investigate the mid-term efficacy of bilateral decompression with a unilateral approach (BDUA) on symptoms and quality of life of in patients with lumbar spinal stenosis (LSS), with low grade (with percentage slip <25%) degenerative spondylolisthesis or without spondylolisthesis. MATERIAL and METHODS: The study included patients who underwent BDUA due to one or two-level LSS related to degenerative spondylosis and/ or degenerative spondylolisthesis. Pre- and postoperative data of the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), and walking distance were compared. RESULTS: Evaluation was made up of a total of 53 patients, comprising 32 males and 21 females with a mean age of 60.6 ± 9.0 years. Compared with the preoperative data, VAS, ODI and walking distance improved significantly in all patients at the 3-year follow-up examination. Furthermore, a significant improvement was determined in the clinical parameters of patients with degenerative spondylolisthesis, with no worsening of slip and no requirement for instrumentation. Moreover, when patients were separated into two groups according to age, as elderly (>60 years) and adult (<60 years), similar improvements were seen in both groups. CONCLUSION: BDUA could be quite effective in reducing pain, improving quality of life and walking distance with no worsening of the grade or degree of slipping.