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To investigate interaction between behind-the-ear (BTE) hearing aids, hearing assistive technologies, and programmable shunt valve to understand how use of BTE hearing aids in patients who underwent ventriculoperitoneal shunt (VPS) surgery affects the settings of a programmable shunt valve.In this study, we investigated the magnetic field (MF) generation of 3 BTE hearing aids made by different companies, 1 frequency modulated system using telecoil technology, and 1 wireless microphone technology and their interactions with 2 programmable shunt valves. All measurements were made in a silent booth using 2 different models. The influence of MF strength in the distance modeling was investigated based on the distance from source auditory prostheses. The measurements were recorded using a Gauss meter. In the anatomical modeling, the change in the settings and interaction of the valve in a bust mannequin were investigated.No MF created by BTE hearing aids was detected in the distance modeling. The highest value measured was 32.67 μT (90 dB noise) when BTE hearing aids and frequency modulated systems were used, and this value decreased as the distance increased. No MF generation was observed at measurements done for distances10 mm. In the anatomical modeling, the settings of both programmable valves did not change under all acoustic conditions.This is the first study to our knowledge examining the MF created by hearing aids and hearing assistive technologies and its impact on programmable valves and variations in their settings. Our findings showed that it is safe to use BTE hearing aids, frequency modulated systems, and wireless microphone technologies in patients with a programmable VPS.

Nöroşirürjide beyin omurilik sıvısı (BOS) fistülü önemli bir komplikasyondur. Hemopatch®’in (Sealing Hemostat – Baxter Healthcare SA, Avusturya) fibrin yapıştırıcı (Tisseel®, Baxter Healthcare SA, İsviçre) ile birlikte kraniyal cerrahide kullanımı ile birlikte literatür değerlendirmesi yapılmıştır. İntrakraniyal kitle nedeniyle ameliyat edilen ve dural kapanma aşamasında fibrin yapıştırıcı ile birlikte Hemopatch® kullanılan 4 hastanın ameliyat sonrası erken ve geç dönem sonuçları irdelendi. Hastaların yaş ortalaması 62.25 ± 10.49 yıl ve ortalama takip süreleri 16.25 ± 3.27 hafta idi. Fibrin yapıştırıcılı Hemopatch® kullanılan hastaların tamamı kraniyal cerrahi (%75 pterional kraniyotomi, %25 retrosigmoid kraniyotomi idi) geçiren hastalardan oluşmaktaydı. Takip sonrasında geniş dura invazyonuna bağlı dural tabakanın tamamen çıkarılarak faysa ve xenogreft ile duraplasti yapılarak Hemopatch® uygulanan 1 hastada (Hasta 1) post operatif erken dönemde Beyin Omurilik Sıvısı (BOS) kaçağı oldu. Sonuç olarak, öncelikle Hemopatch®’in fibrin yapıştırıcılı kraniyal cerrahide dural örtücü olarak kullanılmasının uygulanabilirliğini ve güvenliğini ortaya koyduk.

“Endoskop”; içeri, içeriye anlamına gelen “endo” ve görmek, görüntülemek anlamına gelen “skope” kelimelerinin birleşmesi ile oluşan Yunanca kökenli bir kelimedir. Nöroşirurji alanında endoskop ilk olarak ventrikül içi patolojilerin ve hidrosefalinin tedavisinde kullanılmıştır. Başarısız cerrahi girişimler nedeniyle gündemden düşen nöroendoskop ilerleyen zamanlarda mikrocerrahiye yardımcı olması amacıyla yeniden kullanıma girmiştir.

Background: It is known that interactions between programmable Ventriculoperitoneal Shunt (VPS) valves and electromagnetic and hearing devices may change the valve settings. We reported a patient using programmable VPS valves and hearing devices and reviewed the literature. Case Description: A 71-year-old man was implanted with a programmable VPS valve with the diagnosis of Normal Pressure Hydrocephalus. A hearing device (behind-the-ear) was proposed because of hearing difficulties, but it was suggested that it be discontinued because it did not help. However, the patient used it twice because of his current dementia, forgetting the doctor’s recommendations. The setting of the valve has changed in these two different times that this behind-the-ear hearing device is used. Long-term follow-ups showed no change in valve settings except those two situations. Conclusion: It is important to note that patients using hearing devices and programmable VPS valves are a unique group of patients. There are not enough studies showing the relationship between the behind-the-ear hearing devices and programmable VPS. It should be kept in mind that hearing devices with magnetic field strength may change the setting of the valves.

Parkinson hastalığı (PH) ikinci en yaygın ilerleyici nörodejeneratif olup, genetik vakalar azınlıkta olup, altta yatan etyopatofizyoloji hala bilinmemektedir. Halen, kanıtlanmış ve kesin bir tedavi mevcut değildir. Yeni terapötik stratejilerin taranması ve test edilmesi için kullanılabilecek güvenilir hayvan modelleri geliştirmek çok önemlidir, mesela, sadece semptomatik tedaviler geliştirmek yerine gerçek patojenik süreci hedefleyen kök hücre tedavileri gibi. Burada, PH’nin güncellenmiş in vivo ve in vitro modellerini özetledik ve bu modelleri kullanarak kök hücre temelli deneysel çalışmaları gözden geçirdik.

Objective To evaluate the quality and reliability of carpal tunnel syndrome surgery videos on YouTube. Methods A keyword set of "carpal tunnel syndrome surgery" was searched on YouTube. The DISCERN scoring system, Journal of the American Medical Association (JAMA) scoring system, and Health on the Net (HON) ranking systems were used to evaluate the quality and reliability of the first 50 videos appeared in the search results. The characteristics of each video, such as the number of likes, dislikes and views, upload days, video length, and the uploader, were collected retrospectively. The relationships between the video quality and these factors were investigated statistically. Results All of the featured videos sorted were found to be of poor content (mean DISCERN score [n = 1.71 of 5], mean JAMA score [n = 1.76 of 4], mean HON score [n = 5.65 of 16]). Yet, DISCERN scores of the videos uploaded by medical centers were higher than that of the others (p = 0.022). No relationship was detected between the other variables and video quality. Conclusion Healthcare professionals and organizations should be more cautious when recording and uploading a video to the online platforms. As those videos could reach a wide audience, their content should provide more information about possible complications of a treatment and other treatment modalities.

BACKGROUND Hypoxic-ischemic encephalopathy (HIE) is a leading cause of morbidity and mortality in the adult as well as in the neonate, with limited options for treatment and significant dysfunctionality. AIM To investigate the safety and preliminary efficacy of allogeneic mesenchymal stem cells (MSCs) in HIE patients. METHODS Patients who had HIE for at least 6 mo along with significant dysfunction and disability were included. All patients were given Wharton’s jelly-derived MSCs at 1 × 106/kg intrathecally, intravenously, and intramuscularly twice a month for two months. The therapeutic effects and prognostic implications of MSCs were evaluated by multiple follow-ups. Functional independence measure (FIM), modified Ashworth, and Karnofsky scales were used to assess any side effects, neurological and cognitive functions, and overall outcomes. RESULTS The 8 subjects included in the study had a mean age of 33.25 ± 10.18 years. Mean HIE exposure and mean post-HIE durations were 45.63 ± 10.18 and 19.67 ± 29.04 mo, respectively. Mean FIM score was 18.38 ± 1.06, mean modified Ashworth score was 43.5 ± 4.63, and mean Karnofsky score was 20. For the first 24 h, 5 of the patients experienced a subfebrile state, accompanied by mild headaches due to intrathecally administration and muscle pain because of intramuscularly administration. Neurological and functional examinations, laboratory tests, electroencephalography, and magnetic resonance imaging were performed to assess safety of treatment. Mean FIM score increased by 20.88 ± 3.31 in the first month (P = 0.027) and by 31.38 ± 14.69 in 12 mo (P = 0.012). The rate of patients with an FIM score of 126 increased from 14.58% to 16.57% in the first month and 24.90% in 12 mo. CONCLUSION Multiple triple-route Wharton’s jelly-derived MSC administrations were found to be safe for HIE patients, indicating neurological and functional improvement. Based on the findings obtained here, further randomized and placebo research could be performed.

Objective The aim of this study is to provide essential information for endoscopic transforaminal approach by performing morphometric analysis of the triangular working zone (TWZ) in fresh cadavers. Methods Fifteen fresh human cadavers (9 women and 6 men) with no history of spinal surgery were used in this study. Anatomic dissection of 150 foraminal levels were performed. Significant surgical landmarks constructing TWZ were measured bilaterally from L1–2 to L5–S1 on 15 fresh cadavers. The relationship between traversing roots and intervertebral discs was defined. Results Base, height, and hypotenuse measurements of TWZ were longer as the level lowered. Mean base height and hypotenuse of TWZ were 12.15 mm, 11.29 mm, and 16.69 mm (L1–2); 17.94 mm, 17.18 mm, and 28.03 mm (L5–S1), respectively. TWZ was triangular shaped at the upper lumbar levels (L1–2, L2–3, and L3–4), and trapezoid at the lower lumbar levels (L4–5 and L5–S1). Going down the levels, the exiting root angle was narrower, the mean exiting angle of the L5 root being 28.23°. All L2 and L3 traversing roots and nearly all L4 traversing roots (86.7%) originated from below the disc level. Forty percent of L5 traversing roots originated above the disc level, and 53.3% originated at the disc level. Most S1 traversing roots originated at the proximal margin of the disc level (80%). Conclusions Our study reveals a detailed morphometric analysis of TWZ. Understanding the foraminal anatomy is crucial for safely performing transforaminal endoscopic surgery. The learning curve of transforaminal surgery can be reduced by garnering knowledge of TWZ anatomy.

Aim: To explore the anatomic features of the neural foramen in particularly at the T12-L1 level in order to assess reveal the safety and efficiency of the endoscopic transforaminal approach for paramedian and foraminal disc herniations at this level. Material and Methods: The study included 15 fresh human cadavers. The soft tissues were removed at the T12-L1 level and bony tissues, were exposed including the transverse processes. The bilateral facets and pars interarticulares at this level were resected revealing the foraminal anatomy and exiting roots. The anatomical structures constituting the triangular safe working zone (TSWZ) were explored. The nerve root length, nerve root width, nerve root angle, TSWZ height, and base of TSWZ base, nerve root width, nerve root angle and disc height were recorded. Results: The root length is the hypotenuse of the TSWZ between the axilla of the exiting root and the lateral margin of the pedicle, and the mean root length was 14.94 ± 2.45 mm. The dural height is the interval between the axilla of the exiting nerve root axilla and the superior end plate of the caudal vertebra, and the mean of the dural height was 10.95 ± 1.74 mm. The base of TSWZ is the distance between the lateral margin of the dural sac and the medial margin of the exiting root, and the mean measurement for the base measurement was 11.83 ± 2.26 mm. Conclusion: According to the results data from our cadaveric study, we believe that Kambin’s triangular working zone is a safe area to consider for the endoscopic transforaminal approach at the T12-L1 level, especially for paramedian and foraminal disc herniations.

Aim: To compare short and long term pain intensity changes and long term loss of correction rates in patients who were treated either by kyphoplasty or posterior segmentation due to their TLICS and LSC scores, therefore evaluate the specificity of these classifications. Material and Methods: Medical records of 106 patients operated due to thoracolumbar compression or burst fracture in our clinics between years 2012 to 2015 have been evaluated retrospectively. The patients were evaluated with postoperative radiography (loss of reduction) and visual analogue scale (VAS) in their follow-ups. Results: The average stay on hospital was 6.53 ± 4.51 days in kyphoplasty group. The mean preoperative cobb angle was 10.76±11.67 degrees, which improved to 10.19±10.66 degrees at postoperative 1th month. Beside this, the mean preoperative VAS score was 7.93±0.68 then improved to 4.25±0.77 and 2.75 ± 1.43 at postoperative 6th, 12th month follow-ups respectively. There were 42 patients in instrumentation group. The mean hospitalization was 13.47±10.43 days. The mean preoperative cobb angle was 15.84±10.52 and it improved to 11.86±8.15 degrees at the postoperative 1th-month follow-up. The preoperative VAS scores of the patients improved from 7.71±0.71 to 4.09±0.79 and 4.26±1.23 at 6th and 12th month follow-ups. Conclusion: In long term follow up the kyphoplasty group showed more loss of correction however lesser VAS scores comparing to the instrumentation group. Although evaluating TLICS scores to kyphoplasty patients is still based on case reports in our series it was performed to 64 patients.

Background Hypoxic-ischemic encephalopathy (HIE) is one of the leading causes of death and long-term neurological impairment in the pediatric population. Despite a limited number of treatments to cure HIE, stem cell therapies appear to be a potential treatment option for brain injury resulting from HIE. Aim To investigate the efficacy and safety of stem cell-based therapies in pediatric patients with HIE. METHODS The study inclusion criteria were determined as the presence of substantial deficit and disability caused by HIE. Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs) were intrathecally (IT), intramuscularly (IM), and intravenously administered to participants at a dose of 1 × 106/kg for each administration route twice monthly for 2 mo. In different follow-up durations, the effect of WJ-MSCs administration on HIE, the quality of life, prognosis of patients, and side effects were investigated, and patients were evaluated for neurological, cognitive functions, and spasticity using the Wee Functional Independence Measure (Wee FIM) Scale and Modified Ashworth (MA) Scale. Results For all participants (n = 6), the mean duration of exposure to hypoxia was 39.17 + 18.82 min, the mean time interval after HIE was 21.83 ± 26.60 mo, the mean baseline Wee FIM scale score was 13.5 ± 0.55, and the mean baseline MA scale score was 35 ± 9.08. Three patients developed only early complications such as low-grade fever, mild headache associated with IT injection, and muscle pain associated with IM injection, all of which were transient and disappeared within 24 h. The treatment was evaluated to be safe and effective as demonstrated by magnetic resonance imaging examinations, electroencephalographies, laboratory tests, and neurological and functional scores of patients. Patients exhibited significant improvements in all neurological functions through a 12-mo follow-up. The mean Wee FIM scale score of participants increased from 13.5 ± 0.55 to 15.17 ± 1.6 points (mean ± SD) at 1 mo (z = - 1.826, P = 0.068) and to 23.5 ± 3.39 points at 12 mo (z = -2.207, P = 0.027) post-treatment. The percentage of patients who achieved an excellent functional improvement (Wee FIM scale total score = 126) increased from 10.71% (at baseline) to 12.03% at 1 mo and to 18.65% at 12 mo posttreatment. Conclusion Both the triple-route and multiple WJ-MSC implantations were safe and effective in pediatric patients with HIE with significant neurological and functional improvements. The results of this study support conducting further randomized, placebo-controlled studies on this treatment in the pediatric population. WOS:000661465500008 Q2

two hundred years of design, endoscopy is widely used today in neurosurgical interventions for intraventricular surgery, skull base surgery, spinal surgery and various other applications. Neuroendoscope, which had fallen off the agenda in the early 1900s due to unsuccessful surgical interventions, was re-used to assist microsurgery in the future. It has become an indispensable equipment of the neurosurgery operating room itself, rather than the complementary feature of the neuroendoscopy, which has increased effectiveness in the development of technology. In this article, our aim is to tell the history of neuroendoscopy used in current neurosurgical field to physicians.

The use of stem cells in the treatment of traumatic spinal cord injury (SCI) in recent years has provided promising results. Different sources of cells for transplantation have been used, including mesenchymal stem cells [MSCs; e.g., Wharton’s jelly-derived (MSCs WJ-MSCs)]. Here, we reported on a 29-year-old man who was treated with WJ-MSCs in the course of therapy for blunt, traumatic SCI due to a work accident. He was operated on within 6 hours of the injury. Three and a half months later, he underwent intrathecal, intramuscular, and intravenous administrations of WJ-MSCs at a target dose of 1x106/kg for each application route (twice a month for 2 months). All the procedures were tolerated well by the patient. In parallel to this, we have not seen any application-related complications so far. After stem cell infusions, progressive improvements were shown in the patient’s neurological examination and neurophysiological and neuroradiological findings.

Aim To examine the morphological structure of anterior lumbar spinal region. Material and methods Fifteen fresh human cadavers were studied in our forensic medicine institution. Within the first 24 hours after death, cadavers were subject to a routine autopsy, by which the intestines were removed and the structures adjacent to the lumbar arteries (LAs) were examined. The following characteristics of the LA were examined and recorded: diameter, number of LA, intervertebral disc, and vertebral corpus relationship, and LA anatomical variations. Results In 14 of the 15 cadavers (93.3%), the first four LAs originated from the abdominal aorta. In one (6.7%) cadaver, the fourth LA originated from the right aortic trunk together with the median sacral artery (MSA), and this was observed only in the right side. In one cadaver, the first LAs emerged as a common trunk. Twelve cadavers did not have a fifth LA. In one cadaver (6.7%), the fifth LAs emerged as in a pair, distally from the origin of the MSA. Two cadavers (13.3%) had fifth LAs that emerged from the common trunk with the MSA and this occurred only on the right side. LAs which emerged from the right side of the abdominal aorta passed under the inferior vena cava. Of the first four LA, the third LA had the largest vessel diameter, and the first LA had the narrowest vessel diameter. Fifth LAs had one of the narrowest vessel diameters of all LAs. Conclusion We consider that anatomical study of LAs using fresh cadavers can be useful to ensure safer anterior lumbar spinal surgeries.

Objective: Arteriovenous malformation (AVM) is the most common form of intracranial vascular malformations in adults. Intracranial pediatric AVMs are rare. AVM located in the vicinity of the brain stem in children are even more rare. Case report: This study reports a rare case of acute obstructive hydrocephalus following aqueductal stenosis caused by an unruptured grade IV perimesencephalic arteriovenous malformation. An 11-year-old boy admitted to the hospital with progressive headache, nausea and vomiting throughout a month. A Computerized Tomography (CT) showed an obstructive hydrocephaly. A Magnetic Resonance (MR) imaging revealed a mesencephalic AVM compressing the aqueduct. The patient deteriorated in hours and an emergency ventriculoperitoneal shunting was performed. He did well in the early postoperative period. AVM examined with Digital Subtraction Angiography (DSA) in detail for maintaining the definitive treatment by means of endovascular embolization, microsurgery and stereotactic radiosurgery; but the patient was lost to follow up. Conclusion: A Pubmed search revealed 34 cases of hydrocephalus caused by an unruptured AVM in the literature, and only four cases were less than 18 years old with unruptured AVM locating in brain stem or posterior fossa. Although focal neurologic deficit, seizure and headache are the most common symptoms, acute neurologic deterioration due to hydrocephalus may be the presenting symptom in these cases. The decrease in intracranial pressure by changing the flow of cerebrospinal fluid (CSF) via an emergency ventriculoperitoneal (VP) shunting or Endoscopic Third Ventriculostomy (ETV) can be a lifesaving procedure that gives a chance for further treatment modalities.

Amaç: Torakolomber bileşke disk herniasyonlarının (TLBDH) tedavisi için optimal cerrahi yaklaşım biçimi halen tartışmalıdır. TLBDH’nın güncel cerrahi tedavisinde anterolateral retroperitoneal, anterior transtorasik, posterolateral, lateral ve transforaminal endoskopik yaklaşımlar uygulanmaktadır. Posterolateral transkambin yaklaşımda, pars interartikülaris ve faset ekleminden minimal kemik alınarak, instabiliteye yol açmadan diskektomi ile dekompresyon sağlanmaktadır. Transkambin yaklaşımın, ileri düzeyde nöral doku retraksiyonu olmaksızın diskektomi yapılabilmesi, iyileşme süresinin kısa olması ve postoperatif komplikasyonların daha az görülmesi gibi avantajları vardır. Yöntemler: Kliniğimizde 2016-2018 tarihleri arasında posterolateral transkambin yaklaşım ile ameliyat edilen 3’ü T12-L1 ve 5’i L1-2 TLBDH’lı 8 hasta retrospektif olarak sunuldu. Çalışmamıza far lateral, foraminal ve paramedian uzanım gösteren, klinik olarak kauda ekuina sendromu, konus medüllaris sendromu ve radikülopatiye neden olmuş, ekstrüde veya sekestre disk hernili hastalar dahil edildi. Hastalarda cilt insizyonu ve fasyanın açılışı orta hattan yapıldı. Paravertebral adeleler subperiostal sıyrılarak pars lateralinde çıkan kök açığa konulup sekestre veya ekstrüde disk fragmanlarının alınması hedeflendi. Bulgular: Hastaların 3’ü erkek, 5’i kadın ve ortalama yaşı 45,1 (32- 66) olarak saptandı. Ortalama operasyon süresi 57,8 dakikaydı. Preoperatif VAS değerleri 8,75±0,51, postoperatif VAS değerleri 1,25±0,65 saptandı. MacNab klasifikasyonuna göre postoperatif 6 ay sonraki sonuçları; %62,5‘i mükemmel, %25’i iyi, %12,5’i vasat olarak bulundu. Hastalarda nörolojik hasar, beyin omurilik sıvısı (BOS) fistülü, pnömotoraks ve operasyon lojunda hematom gelişmedi. Sonuç: TLBDH’li hastalarda transkambin yaklaşım, görece kısa operasyon süresi, düşük morbidite olasılığı ve daha az postoperatif ağrıya sebep olması açısından yararlı bir yaklaşım olarak bulunmuştur., Objective: The optimal surgical approach for treatment of thoracolumbar junction disc herniations (TLJDH) remains controversial. Anterolateral retroperitoneal, anterior transthoracic, posterolateral, lateral and transforaminal endoscopic approaches are used in current surgical treatment of TLJDH. In a posterolateral transcambin approach, a small piece of bone is removed from the pars interarticularis and facet joints, and decompression is achieved by discectomy without causing instability. The transcambin approach has advantages such as discectomy without advanced neural tissue retraction, short recovery time and less postoperative complications. Methods: The eight patients with 3 T12-L1 and 5 L1-2 TLJDH who were operated on using the posterolateral transcambin approach between 2016-2018 in our clinic were presented retrospectively. The study included patients with extruded or sequestrated disc herniation that had far lateral, foraminal, and paramedian extension, and caused cauda equina syndrome, conus medullaris syndrome, and radiculopathy. A skin incision and fascia opening were done from midline. The exiting root was revealed at laterally of pars interarticularis by subperiosteally stripping of paravertebral muscles and the removal of disc fragments were targeted. Results: Three male and five female patients with a mean age of 45.1 (32-66). Mean operation time was 57.8 minutes. Preoperative VAS values were 8.75±0.51 and postoperative VAS values were 1.25±0.65. According to the MacNab classification, 62.5% excellent, 25% good and 12.5% were fair. There was no neurological injury, cerebrospinal fluid (CSF) fistula, pneumothorax, or operation field hematoma. Conclusion: The transcambin approach was found to be useful in terms of a relatively short operation time, low morbidity probability, and less postoperative pain in patients with TLJDH.

Objective: Although spondylodiscitis seen after lumbar discectomy is very rare, its incidence has been reported to be around 0.1-18.8\% by many different authors. The most common pathogen is Staphylococcus aureus. Methods: Medical records of 1,154 patients who were operated in our hospital between 2007 and 2015 due to a single or two-level lumbar disc hernia were retrospectively extracted. Of these patients, 554 were female and 600 were male. Discectomy operation was performed in 1,062 of these patients with single-level and 91 with two-level lumbar microdiscectomy. All of these patients were given a prophylactic single dose of cefazolin sodium in accordance with the recommendations of the surgical antimicrobial prophylaxis guidelines during anesthesia. Spondylodiscitis developed in 12 patients (1.03\%). Comorbidities in patients who developed spondylodiscitis, isolated pathogens, antibiotic susceptibility, antibiotics used, and hospital stay were noted. Results: Of the 12 patients, 7 were female and 5 were male. Mean age was 45.75 +/- 14.16 years. Eleven of these patients underwent single level, one had 2 levels of lumbar microdiscectomy. Five patients underwent discectomy at L4-5 and 8 patients at L5-S1 levels. Three of these patients had S. aureus (25\%), 4 had Staphylococcus epidermidis (33\%) and 3 had Escherichia coli (25\%) and 2 patients had no reproduction. The mean hospital stay was 29.45 +/- 3.98, and in patients without spondylodiscitois it was 1.99 +/- 0.81, the two groups were significantly different from each other (p=0.0001). Conclusion: Although most surgeons nave a tendency to maintain antibiotic prophylaxis postoperatively or during hospitalization period, our study found that a single dose prophylactic antibiotic administered during anesthesia induction did not increase rate of spondylodiscitis by medical literature.

AIM: To introduce a traumatic brain injury (TBI) patient who underwent stem cell transplantation (SCT) in order to minimize the remaining injury deficiencies. MATERIAL and METHODS: This study included a 29 years old male who had TBI resulting from a vehicle accident which took place one and a half years ago. The participant received six doses of intrathecal, intramuscular, and intravenous transplantation of Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) at a goal dose of 1 x10(6) / kg respectively for each route of administration for six months. RESULTS: No important negative effects were reported. The patients' speech, cognitive, memory and fine motor skills were improved. The efficacy of treatment with SCT was assessed with cranial magnetic resonance imaging (MRI), computed tomography (CT) screening, and electroencephalography (EEG). CONCLUSION: SCT can have a promising future as a medical approach in recurrent TBI. AIM: To introduce a traumatic brain injury (TBI) patient who underwent stem cell transplantation (SCT) in order to minimize the remaining injury deficiencies. MATERIAL and METHODS: This study included a 29 years old male who had TBI resulting from a vehicle accident which took place one and a half years ago. The participant received six doses of intrathecal, intramuscular, and intravenous transplantation of Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) at a goal dose of 1 x10(6) / kg respectively for each route of administration for six months. RESULTS: No important negative effects were reported. The patients' speech, cognitive, memory and fine motor skills were improved. The efficacy of treatment with SCT was assessed with cranial magnetic resonance imaging (MRI), computed tomography (CT) screening, and electroencephalography (EEG). CONCLUSION: SCT can have a promising future as a medical approach in recurrent TBI. WOS:000593272300017 Q4

Objective: The incidence of spondylodiscitis following lumbar discectomy has been reported to range between 0.1\% and 18.8\% by various authors. The most common pathogen is Staphylococcus aureus. Methods: We collected retrospectively the medical records of 1154 patients who had the single-level or two-level disc herniation and were operated for lumbar microdiscectomy between 2007 and 2015 in our hospital. Of them, 554 were female and 600 were male. A total of 1062 patients underwent single-level, 91-level two-level lumbar microdiscectomy. All of these patients were given prophylactic single-dose cefazoline sodium during anesthesia in accordance with the recommendations of the surgical antimicrobial prophylaxis guidelines. Spondylodiscitis developed in 12 patients (1.03\%). The comorbidities in patients treated for spondylodiscitis, isolated pathogens, antibiotic susceptibility, antibiotics used, and hospital stay were recorded. Results: Of the 12 patients, 7 were female and 5 were male. The mean age was 45.75 +/- 14.16 years. Eleven patients underwent single-level, and 1 two-level lumbar microdiscectomy procedures. 5 patients underwent discectomy from L4-5 and 8 patients from L5-S1 levels. Staphylococcus aureus was present in 3 patients (25\%), Staphylococcus epidermidis in 4 (33\%), Escherichia coil in 3 (25\%), and 2 patients had no detected pathogens. The mean duration of hospital stay was 29.45 +/- 3.98 days, and in patients without spondylodiscitis, it was 1.99 +/- 0.81 days, meaning that there was a significant difference between these groups (p=0.0001). Conclusion: Although most surgeons tend to maintain antibiotic prophylaxis postoperatively or during the hospitalization period, our study found that a single dose prophylactic antibiotic administered during anesthesia induction did not increase the rate of spondylodiscitis, compared to the results found in the medical literature.

Objective: Endoscopic interventions are rapidly replacing conventional methods in neurosurgical applications. The main purpose of this study was to examine the neurovascular structures in the pons-cerebellum cistern in detail through the endoscopic retrosigmoid suboccipital approach and to make morphometric measurements. Methods: In five human dry cadavers, pons-cerebellum cisterna was examined by endoscopic retrosigmoid approach. Relations with the vascular structures surrounding the nerves, the dimensions of the craniectomy diameter, the distances of the petrosal vein and the trigeminal and facial-vestibulocochlear nerves to the dura, the length of the nerves, the diameter of the trigeminal nerves, and the distance between the nerves and petrosal vein were measured. Results: The distances between the dura and the petrosal vein, trigeminal nerve and facial-vestibulocochlear nerves were 34-53 mm (mean, 43.5 mm), 46-62 mm (mean, 54.1 mm), and 37-47 mm (mean, 42 mm), respectively. The diameter of the trigeminal nerve was measured as 1.27-3.27 mm (mean, 1.8 mm). The distances between the petrosal vein and the trigeminal nerve and facial-vestibulocochlear nerves were 6-13 mm (mean, 9.5 mm) and 6-12 mm (mean, 8.6 mm), respectively, and the distance between the trigeminal nerve and facial-vestibulocochlear nerves was 9-15 mm (mean, 10.1 mm). Arterial compression was observed at the five trigeminal nerves and five fascial-vestibulocochlear nerves. Conclusion: In this study, pons-cerebellum cistern and anatomical neurovascular structures in this place were able to examine with endoscope in detail. Vascular compression was frequently observed in trigeminal nerve and facial-vestibulocochlear nerves.