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Objective: Vertebroplasty (VP) is a commonly used technique for the treatment of osteoporotic vertebral fractures (OVF). The aim of the study is to compare general anesthesia (GA) and local anesthesia (LA) applications for VP. Materials and Methods: Patients who underwent VP for a single-level OVF were included in to the study. Visual analog scale (VAS), demographic characteristics, operative time, mean arterial pressure (MAP), heart rate, length of stay in intensive care and hospital, complications, side effects, kyphotic angle (KA) and anterior vertebral height (AVH) of the vertebral body were compared between groups. Results: Eighty patients (52 female, 28 male) were included and divided into two groups: As GA, group 1, and as LA, group 2. There was statistical significant differences between preoperative VAS scores, KA, AVH compared to postoperative period in both groups (p<0.05). There was no difference between the groups in terms of recovery rates of these variables, complications and side effects (p>0.05). Heart rate and MAP was lower in group 1 (p<0.05). Conclusion: VP is a minimally invasive method that provides pain relief and restoration of the fractured vertebrae. Our study showed there is no difference in the success, complication and side effect rates of VP surgeries performed with both anesthesia methods. LA may be an alternative method to GA as the primary anesthetic option for VP operations. VP can be performed under local anesthesia to avoid complications of GA and shorten the length of stay in the hospital especially in high-risk patients. [ABSTRACT FROM AUTHOR]

Objective: There is almost no controversy about the conservative treatment of patients with fractures with a Thoracolumbar injury classification and severity score (TLICS) of 1-3. External thoracolumbosacral orthosis is the recommended method. However, it is still controversial to support the TLICS with radiological parameters. The aim of this study was to evaluate the correlation between TLICS scores of 1-3 and clinical and radiological results of patients with stable thoracolumbar and lumbar vertebrae fractures, who were followed up conservatively. Materials and Methods: This retrospective study included patients diagnosed as having TLICS 1 to 3 thoracolumbar or lumbar vertebrae fractures who were followed up conservatively. Data were gained from the patient files. Outcome measures and classification parameters used were; visual analogue scale (VAS) and Turkish version of Oswestry disability index (ODI). The radiological parameters were measured. The recovery rates of all patients were evaluated, and correlation between clinical and radiological outcomes of the patients and TLICS scores was analyzed. Results: The mean duration of hospitalization and time to return to work were 1.61 and 126 days, respectively. Both VAS and ODI values steadily decreased over time. However, local kyphotic angle (LKA) and vertebra height loss (VHL) percentage values increased over time. TLICS did not correlate with the time to return to work. However, LKA at admission and VHL percentage at admission correlated significantly with the time to return to work. Conclusion: The TLICS classification seems to be effective in decision making in the conservative treatment of thoracolumbar and lumbar vertebral fractures, but it would be noteworthy to take into account the clinical and radiological parameters in this classification to predict the treatment period and time to return to work. [ABSTRACT FROM AUTHOR]

Objective: The information available on the association between transforaminal lumbar interbody fusion (TLIF) surgery and adjacent segment degeneration (ASD) in lumbar spinal stenosis (LSS) patients is extremely limited. To explore the risk factors involved in the development of ASD after decompression and fusion surgery for LSS. Materials and Methods: This study subjects were patients who underwent lumbar posterior segmental instrumentation and spinal decompression surgery for degenerative LSS, in L4-5 or L5-S1, during 2010-2015. These patients were classified into two groups based on their stage of ASD development. The diagnosis of ASD was based on magnetic resonance imaging findings. The study groups were compared to determine the risk factors for ASD. Results: A total of 162 patients (68 men, 94 women) of a mean age 60.76±6.4 years (age range: 37-89 years) were evaluated. The mean followup period for these patients was 67.42±5.6 months. Decompression surgery with TLIF was applied to 67 patients, while decompression surgery without TLIF was applied to 95 patients. Overall, ASD developed in 40 patients (24.7%). The type of stenosis was found to be a risk factor for ASD. Conclusion: Our results suggested that, although instrumentation and fusion applied to the surgical area caused an increase in stress and degeneration in the adjacent segment owing to immobilisation and stiffness in this area, the rate of increase did not rise with TLIF cage. Furthermore, the type of stenosis was determined to be a risk factor for ASD in our study. [ABSTRACT FROM AUTHOR]

Objective: Discussions regarding the effectiveness of unipedicular kyphoplasty in osteoporotic thoracolumbar vertebral fractures are found in the literature. To evaluate the clinical and radiologic efficacy of percutaneous unipedicular kyphoplasty in thoracolumbar osteoporotic vertebral compression fractures (OVCFs) in elderly patients. Materials and Methods: Our study was conducted as a retrospective analysis. We enrolled patients who underwent percutaneous unipedicular kyphoplasty due to thoracolumbar OVCFs between January 2015 and December 2018. All patients were evaluated through two-planed radiographs and computed tomography scans. The local kyphosis angle (LKA) and vertebral corpus height (VCH) of the fractured vertebrae were measured. The Visual Analogue scale (VAS) and Oswestry Disability index (ODI) were used to determine the functional outcomes of patients. Results: We included 77 patients (28 men, 49 women) with a mean of age 76.64±5.5 years (range, 69-86 years). In this study, all patients showed better improvement in ODI scores and LKA, increased VCH and decreased VAS scores 24 months postoperatively compared with preoperative values (p<0.05 for all). As a local complication, cement leakage from the kyphoplasty cannula tract to the posterior of the corpus was found in six patients, and cement leakage to the anterior was found in four patients. Conclusion: Percutaneous unipedicular kyphoplasty is a reliable method with satisfactory clinical and radiologic results in thoracolumbar OVCFs in elderly patients. [ABSTRACT FROM AUTHOR]

objective: The efficiency and cost of cell saver system is compared with in patients who underwent to complex spine surgery with and without the system. Material and methods: We restrospectively evaluated the patients who underwent to posterior instrumentation and fusion in our clinic between Jan 2009-Mar 2013 for treatment of complex spine disease. There were 44 patients in group I which cell saver system was used during operation, and 20 patient in group II which system was not used. We aimed to determine the efficiency and cost of the usage of cell saver system against to allogenic blood transfusion in peroperative and postoperative periods. IBM SPSS Statistic Version 20.0 program was used for statistical analyses. Results: The number of erytrosyte suspension used in the peroperative and the postoperative periods was 1±1 in group I, and 2.6±1.8 in group 2 and the difference was statistically significant (p=0.004). When compared by the cost, group I was 752.7±148.7 TL and group II was 241.8±169.1 TL with statistically significant difference (p<0.00l). Conclusion: in complex spine surgery, hemoglobin, hematocrit and red blood cell values are higher at the first postoperative day in patients whom cell saver system is used during operation against whom did not used and the usage of this system decreases allogenic blood transfusion at the peroperative and the postoperative periods. [ABSTRACT FROM AUTHOR]

Objective: In this study, the efficiency of three different rigid screw types on preserving reduction in Lindgren-Turan osteotomy is investigated. Material and Methods: Between 2007-2012, 86 feet of 60 patients who underwent Lindgren-Turan osteotomy procedure due to hallux valgus deformity in our clinic were retrospectively evaluated. Fixation was done by Herbert screws, cannulated headless screws and 2.7 mm cortical screws. Hallux valgus angles, intermetatarsal angles and distal metatarsal articular angles were evaluated in preoperative, early postoperative and late postoperatively. Different rigid internal screws which are used in fixation after Lingdren-Turan osteotomy were evaluated by these angles. Results: While there was no statistically significant difference between averages of hallux valgus angles at early and late postoperative controls in cannulated headless group, the difference was significant in Herbert screw and 2.7 mm cortical screw groups. While there was no statistically significant difference between averages of intermetatarsal angles at early and late postoperative controls in cannulated headless and Herbert screw groups, the difference was significant in 2,7 mm cortical screw group. There was no statistically significant difference between averages of distal metatarsal articular angles at early and late postoperative controls in all screw groups. Conclusion: In fixation of osteotomy site by 2.7 mm cortical screws after Lindgren-Turan osteotomy, there was significant correction decrement at late postoperative intermetatarsal and hallux valgus angles. There was less reduction loss with cannulated headless screws in our study. [ABSTRACT FROM AUTHOR]

Objective: In this study, we purposed to evaluate the early and mid term results and life quality of the patients who underwent to arthroscopic cartilage debridement and joint lavage because of symptomatic gonarthrosis which didn't response to medical treament at least three months, restricted the patient's daily activity and wasn't at the late stage radiologically. Material and Methods: We made our study between 2004-2010 with 96 patients over forty years who applied to our clinic and came to their controls periodically because of knee pain which did not remit by conservative treatment at least three months, had gonarthrosis diagnosis according to modified ACR criteria, under 4. Stage according to Kellgren-Lawrence criteria radiologically and underwent to arthroscopic cartilage debridement and articular lavage because of symptomatic gonarthrosis. We evaluated the life quality, pain and functional scores of the patients pre and post-operatively by SF-36 and WOMAC point index. (Number Cruncher Statistical System) 2007 & PASS 2008 Statistical Software (Utah, USA) program was used for statistical analyze. The results are evaluated with Student t test ve Mann Whitney U test. p<0.05 was statistically significiant Results: In our study we found that the postoperatively physical and social functions, mental health and total SF-36 scores are increased, WOMAC scores are decreased statistically significantly (p<0.0l). We found that the difference between preoperative and postoperative WOMAC and SF-36 scores were not different statistically between two groups whose BMI<30 and BMI≥30 (p>0.05). Physical and social functions, mental health and total SF-36 scores of the patients who underwent to operation in the last 18 months were statistically significantly increased against the patients whose operation time was earlier (P<0.01). Physical and social functions, mental health and total SF-36 scores of the patients who are under 50 were statistically significiantly greater than patients over 50 (p<0.01). Conclusion: The arthroscopic joint debridement and lavage can be used, cheap, low morbid method to improve life quality, functions and to recruit the pain when applied on well chosen patients. [ABSTRACT FROM AUTHOR]