35 research outputs found
Perthes Syndrome associated with intramedullary spinal cord hemorrhage in a 4-year-old child: a case report
No full textBiomechanical Analysis of Interbody Device in Calf Corpectomy Model
No full textIntroduction: The aim of this study is to evaluate the biomechanical properties of the interbody device which is used in thoracic trauma, infection and tumor surgery in valf model. The comparison in between anterior interbody application, anterior, posterior and anterior posterior instrumentation combinations is also stated. The statical applications of interbody device in conditions with anterior interbody applications, anterior, posterior and anterior+posterior instrumentation combinations are done through the gain of stiffness and displacement. In this biomechanical study, instrument stiffness and displacement values are measured and evaluated under axial loading
Morphologic evaluation of cervical and lumbar facet joints: intra-articular facet block considerations.
No full textSTUDY DESIGN: Needle orientations for lumbar and cervical facet injection were measured in cadavers and compared with facet angles measured on magnetic resonance images (MRIs). OBJECTIVES: To establish facet orientation relative to clinical procedures of a facet joint block in the cervical and lumbar spine. METHODS: Needle orientation angles were measured from 20 unembalmed human cadaveric specimens (13 cervical and 7 lumbar). Spinal needles were inserted into the midpoints of the facet joint spaces from C3 to C7 and L1 to L5. Needle trajectories were measured with an optical tracking system. For comparison, facet angles from 100 clinical MRIs of lumbar spines were also measured. Facet orientations on MRIs were measured at their intersection with the transverse plane, and angles were quantified using image analysis software. RESULTS: Typical angles for insertion of the needle into the cervical facets were oriented closer to the coronal plane, whereas insertion angles for lumbar needles were oriented closer to the sagittal plane. Relative to the sagittal plane, the mean cervical angle was 72 degrees and the mean lumbar angle was 33 degrees. The insertion points of the cervical facets were a mean of 29 mm from the midsagittal plane compared with a mean of 22 mm for the lumbar facets. MRI-based facet joint angles correlated poorly with actual injection angles, which were overestimated 5 to 23 degrees, depending on the lumbar level. CONCLUSIONS: Knowledge of the quantitative anatomy of the facets may help improve clinical diagnosis and treatment. These data also may aid in constructing more realistic computer simulations
Intraperitoneal Alpha-Lipoic Acid to prevent neural damage after crush injury to the rat sciatic nerve
No full textMicrosurgical endoscopy-assisted presigmoid retrolabyrinthine approach with mastoid bone drilling: an anatomical laboratory investigation
No full textPurpose This study aims to evaluate the applicability of the endoscopy-assisted presigmoid retrolabyrinthine approach, advantages, disadvantages, and the applicability of surgery with pre-op radiological parameters; identify important landmarks; and to reveal their relationships with important structures in the surgical field with objective data. Also, we aim to improve the surgical technique for increasing reachable anatomic structure. Methods Mastoid drilling and endoscopy-assisted presigmoid retrolabyrinthine approach were performed and endoscopic instruments were used to obtain the three-dimensional pictures. Computed tomography images were evaluated to correlate to the anatomic data. Results In terms of pre-operative radiological evaluation of the applicability of the presigmoid approach were investigated with selected radiological parameters. The endoscopy-assisted presigmoid retrolabyrinthine approach applied to cadavers the relationship, distances between important anatomical landmarks, and anatomical structures in the surgical field recorded. The anatomical structures that could reach with the application of the procedure were recorded. The relationship between pre-operative measured radiological parameters and surgical results was evaluated with objective data. Additional combinations to improve this surgical method discussed and the results of our combination were recorded with photographs. Conclusion Although the presigmoid retrolabyrinthine approach has facilitated with the assistance of endoscope, it has observed that there are still some difficulties, and it has been concluded that the radiological parameters are useful in evaluating the applicability of this surgery. It observed that this surgery can be performed more effectively with combinations
Pneumothorax, pneumomediastinum, tracheo-esophageal fistula presenting with endotracheal intubation in post-cesarean period: A case report
No full textThe benefits of inferolateral transtubercular route on intradural surgical exposure using the endoscopic endonasal transclival approach
No full textBackground Surgical access to the ventral pontomedullary junction (PMJ) can be achieved through various corridors depending on the location and extension of the lesion. The jugular tubercle (JT), a surgically challenging obstacle to access the PMJ, typically needs to be addressed in transcranial exposures. We describe the endoscopic endonasal transclival approach (EETCA) and its inferolateral transtubercular extension to assess the intradural surgical field gained through JT removal. We also complement the dissections with an illustrative case. Methods EETCA was surgically simulated, and the anatomical landmarks were assessed in eight cadaveric heads. Microsurgical dissections were additionally performed along the endoscopic surgical path. Lastly, we present an intraoperative video of the trans-JT approach in a patient with lower clival chordoma. Results The EETCA allowed adequate extracranial visualization and removal of the JT. The surgical bony window-obtained along the clivus and centered at the JT via the EETCA-measured 11 x 9 x 7 mm. Removal of the JT provided an improved intradural field within the lower third of the cerebellopontine cistern to expose an area bordered by the cranial nerves VII/VIII and flocculus superior and anterior margin of the lateral recess of the fourth ventricle and cranial nerves IX-XI inferiorly, centered on the foramen of Luschka. Conclusions Removal of the JT via EETCA improves exposure along the lower third of the cerebellopontine and upper cerebellomedullary cisterns. The inferolateral transtubercular extension of the EETCA provides access to the lateral recess of the fourth ventricle, in combination with the ventral midline pontomedullary region
Investigation of the Relationship of Two-Glass Test with Prostate Biopsy and Presence and Grade of Asymptomatic Prostate Inflammation in Men with Serum Prostate-Specific Antigen Level Between 2.5-10 ng/ml
No full textObjective: Prostate-specific antigen (PSA) is utilized as a marker to detect prostate cancer. Elevated PSA levels often lead to prostate biopsy to assess the potential presence of cancer. However, PSA elevation is not specific to cancer and can be caused by various conditions, including benign prostatic hyperplasia (BPH), urinary tract infections, and chronic prostatitis. Notably, approximately 66% of patients undergoing biopsy do not have prostate cancer, leading to unnecessary procedures and associated complications. Chronic prostatitis is detected in around 40% of these biopsies. The two-glass test involves examining urine before and after a rectal examination to diagnose chronic prostatitis. This study aims to investigate the effectiveness of the two-glass test in predicting prostatitis and inflammation in patients with PSA levels between 2.5-10 ng/ml who have undergone prostate needle biopsy. Materials and Methods: The study included fifty-two male patients aged between 50 and 78 years with PSA levels between 2.5 and 10 ng/ml who presented to our clinic. All patients underwent the EPS-two-glass test and prostate biopsy. EPS (expressed prostatic secretion) is obtained by collecting fluid from the urethra after prostate massage, while VB-3 (voided bladder-3) is urine collected after a massage. These samples are used to detect prostate infection. Prostate inflammation was deemed significant if >= 10 leukocytes were observed under the microscope. Patients were categorized into three groups based on pathology results: prostate cancer, BPH, and chronic prostatitis. The chronic prostatitis group was further classified based on histopathological calcification described by Nickel. Results: Chronic prostatitis was detected in 38% of the study participants. VB3 positivity was significantly higher in the chronic prostatitis group compared to the other groups (p = 0.028). Although no significant difference was observed in the prevalence of inflammation and PSA elevation, PSA levels were higher in the multifocal inflammation subgroup compared to the focal inflammation group. Conclusions: The relationship between chronic prostatitis and PSA elevation remains unclear. Although this study did not find a statistical relationship between inflammation and PSA elevation, the significant correlation between chronic prostatitis and VB3 positivity suggests a potential link. These findings can serve as a foundation for further research aimed at reducing unnecessary biopsies
Microsurgical Perspective for Uncommon Variations Associated with the Vertebrobasilar Junction: An Anatomical and Radiologic Investigation
No full textCerrahpaşa Medical JournalObjective: Anatomic variations of the vertebrobasilar junction have been described as uncommon, but may have important neurosurgical implications. The aim of this study is to emphasize the importance of the variations during the surgery and report the frequency of detected uncommon variations through cadaver dissection and computed tomography angiography. Methods: A combined cadaveric and radiologic study was performed to assess for basilar artery fenestration, intervertebral transversal anastomosis, and persistent primitive lateral vertebrobasilar anastomosis. Thirteen formalin-fixed human cadaveric heads were perfused with red- and blue-colored silicone and dissected in a stepwise manner through an endoscopic endonasal transclival approach. Radiologic data from 887 subjects were retrospectively analyzed for the presence of intervertebral transversal anastomosis. Results: Basilar artery fenestration was found in 7 patients (0.8), intervertebral transversal anastomosis in 1 (0.1), and persistent primitive lateral vertebrobasilar anastomosis in 1 (0.1) by CTA analysis. Conclusion: Anatomic variations of the vertebrobasilar junction are a rare, but important, finding in vascular neurosurgery practice. We also report the first case of intervertebral transversal anastomosis discovered through human brain dissection
