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We compared the clinical and radiological outcomes and complications of patients treated for thoracolumbar burst fractures via temporary percutaneous osteosynthesis or open definitive arthrodesis.A retrospective case-control study was performed including patients treated between 2017 and 2019 for a burst fracture of the thoracolumbar junction, either with percutaneous osteosynthesis (case group) or open arthrodesis (control group). Clinical, functional, and radiographic results were analyzed and compared between treatment groups.We included 112 patients (56 osteosynthesis/56 arthrodesis, P = 1) in our study. The mean follow-up and mean age were 20 ± 3 months (20 ± 2/20 ± 3, P = 1), and 41 ± 10 years (40 ± 11/42 ± 10, P = 0.3), respectively. Fracture level was L1/L2 in 75% and T11/T12 in 25% of patients. The osteosynthesis group showed significantly shorter operative times (104 ± 20 minutes/176 ± 18 minutes, P 0.01) and inpatient stays (11.6 ± 1.5 days/15.6 ± 3.8 days, P 0.01). Both groups showed similar correction over kyphosis angle at final follow-up (5.8° ± 2.8°/6° ± 0.2°, P = 0.57), but the osteosynthesis group showed increased segment mobility after hardware removal (3.8° ± 1.2°/0.9° ± 0.3°, P 0.01). There were no significant differences in complications, although the osteosynthesis group showed a significantly lower need for blood transfusion (21%/43%, P = 0.02).Both methods of treatment yielded good clinical and radiological results with similar complication rates. Temporary osteosynthesis seems to be more beneficial than open arthrodesis because it requires shorter operative time and hospitalization, causes less bleeding, and facilitates spinal movement.

AIM We reevaluated the medulloblastoma cases according to their histomorphological and molecular features and we aimed to investigate the relationship between the prognostic factors of the new WHO classification by applying Beta-catenin, YAP1, GAP1, P53, and INI1 antibodies immunohistochemically. MATERIAL AND METHODS This study includes 41 patients who have been diagnosed as medulloblastoma between 2007-2019 in Pathology Department. Immunohistochemically, P53, Beta-catenin, YAP1, GAP1, and INI1 immune markers were applied and the relationship between the results and the prognostic parameters were evaluated statistically. RESULTS When 41 patients were divided into WHO medulloblastoma histological subtype groups according to histomorphological features:22 (53.7%) patients were classified as classical type, 11 (26.8%) patients as desmoplastic nodular type and 8 (19.5%) patients as large cell/anaplastic type medulloblastoma. According to their molecular characteristics, 14 (34.1%) patients were in the Non-WNT/SHH group, 5 (12.2%) patients were SHH mutant, 17 (41.5%) patients were SHH wild, and 5 (12.2%) patients were in the WNT active group. There was no statistically significant correlation between age, gender, tumor size, recurrence, Ki67 proliferation index with molecular types and histopathological types. CONCLUSION In our study, metastasis at the time of diagnosis, histological large cell anaplastic type, immunohistochemical p53 positivity, molecular SHH mutant type were the statistically significant the indicators of worse prognosis and shorter survival time.

Objective Spinal cord injuries generate the most negative response to medical treatment among all general body injuries. This important morbidity is thought to be caused by a complex secondary damage mechanism. In the present study, we examined the neuroprotective effects of alemtuzumab in a spinal cord trauma model. Methods We divided 24 Long-Evans male rats into 4 groups (n = 6 per group). Laminectomy was performed at T5–T8 in all groups. Trauma was applied using the Yasargil temporary aneurysm clip for 60 seconds at these spinal cord levels in all groups, except for group 1. Next, 1 mg/kg of alemtuzumab was administered to each rat in groups 3 and 4. A functional evaluation was performed on days 1, 3, and 5 in groups 1, 2, and 4, and the rats were then sacrificed. The rats in group 3 were sacrificed on the third postoperative day to observe the early effects of alemtuzumab. The biochemical examination findings of malondialdehyde and glutathione in plasma and tissue samples and histopathological findings of the spinal cord were evaluated and compared by statistical analysis. Results The inflammatory findings in the trauma group were not seen in either group treated with alemtuzumab. The clinical motor examination and inclined plane test results were also significantly better in these groups. Conclusion Our results have shown that alemtuzumab might prevent spinal cord injury after trauma and is a histopathologically and biochemically strong anti-inflammatory, antioxidant, and neuroprotective agent.

Objective: Carpal Tunnel Syndrome (CTS) is the most frequently encountered entrapment neuropathy. Surgical treatment is usually suggested to patients with severe symptoms. In this study, we aimed to examine the effect of the dominant hand on the clinical results of CTS decompression surgery.

AIM: Stent assisted coiling (SAC) is an alternative in the treatment of ruptured aneurysms. Stenting requires the use of dual antiplatelet agents. Hydrocephalus is a complication of subarachnoid hemorrhage (SAH) and may require ventriculostomy. Antiplatelet treatment carries a risk of hemorrhage in ventriculostomy. The anti-aggregant effect starts at least four hours after the initial doses of treatment. However, in many studies, ventriculostomy was performed before antiplatelet treatment and hemorrhagic complications were related to the procedure. The aim of this study was to determine the risk of ventriculostomy related hemorrhage in patients with impaired thrombocyte function and to contribute to the literature. MATERIAL and METHODS: Between 2011 and 2016, 53 patients treated with SAC due to SAH in our clinic were retrospectively evaluated. Hemorrhagic complication risks due to antiplatelet therapy related to ventriculostomy were also evaluated. RESULTS: All of the ventricular catheter procedures were performed at least 1 day after the dual therapy (in average 4.3 days after SAC). In 5 patients 1 ventriculostomy was performed, in 2 patients 2, and in 1 patient 6 ventriculostomies were performed. Although radiological hemorrhage was present on the catheter tract in 4 patients, no temporary or permanent neurological deficit was observed. CONCLUSION: Impaired thrombocyte functions pose a risk in ventriculostomy. Also, evaluating the risk of hemorrhage before the antiplatelet treatment reaches its full effect may lead to false results. Studies with small patient groups with anti-aggregant therapy and impaired thrombocyte functions also contribute to the literature. Larger studies regarding this subject are needed.

AIM To demonstrate the incidence of screw misplacement and revision rates in a group of 72 patients that underwent pedicle screw fixation for spinal pathologies using the conventional, fluoroscopy-guided open technique. MATERIAL AND METHODS Data from 72 consecutive patients with spinal instability that received 472 screws between April 2011 and May 2013 were reviewed and pedicle wall breach was graded as mild ( 6 mm). Direction of misplacement was also assessed in reformatted images as medial, lateral, superior and inferior (or in combinations). RESULTS The indications for pedicle screw placement were as follows: degenerative (59.7%), trauma (13%) and tumor (9.7%). Pedicle screws were inserted between T9 and S1. In this series of the 472 screws, 29 (6.1%) screws were implanted with minimal pedicle wall violation (≤ 3 mm) and 16 screws (3.4%) were implanted with moderate (3-6 mm) violations. There were no severe violations (more than 6 mm) in this series. Pedicle violations were significantly higher in thoracic pedicles and in trauma patients when compared to other groups. Only two patients required pedicle screw repositioning after their index surgery. CONCLUSION Conventional open technique in pedicle screw placement is a safe and sound method with its low and acceptable complication rates.