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    Radicular Pain Outcomes for Disc Hernia Patients Undergoing Microdiscectomy: The Role of Early Preoperative Pain Duration
    (Bayrakol Medical Publisher, 2023) Ozden, Mahmut; Ozturk, Guelsah; Bozkurt, Melih
    Aim: This study aims to determine whether early duration of pain before microdiscectomy in patients with lumbar disc hernia and radicular pain influences postoperative pain outcomes evaluated by the Visual Analog Scale (VAS). Material and Methods: The study included 124 patients (68 males, 56 female), who underwent lumbar microdiscectomy. The patients' demographic features, anatomical features of disc hernia, motor paresis, and VAS values were retrospectively determined and statistically analyzed using the Number Cruncher Statistical System software. Results: As expected, microdiscectomy significantly reduced pain intensities as assessed inthe immediate postoperative period, at the 3rd and 6th months of the postoperative period. But when patients were stratified according to the median preoperative pain duration (14 days), there was no statistically significant difference between patients with pain lasting shorter or longer than the median pain duration. Further, Spearman correlation statistics also did not reveal a significant association between preoperative duration and postoperative VAS pain scores. Discussion: For early intervals of pain during the initial manifestation of the lumbar disc disease, patients will equally benefit from surgical treatment regardless of the pain duration. Therefore, in lumbar radicular pain, it would be appropriate to avoid being too hasty in the surgical decision in the early period and to better weigh the benefits and risks of surgery if there is no neurological deficit and unbearable pain.
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    Surgery in Intracerebral Arteriovenous Malformations: The Role of Preoperative Embolization
    (Turkish Neurosurgical Soc, 2023) Ozden, Mahmut; Erdogan, Koral; Bozkurt, Melih
    AIM: To examine the outcomes of microsurgery only versus combined microsurgery and embolization in treating cerebral arteriovenous malformations (AVM). MATERIAL and METHODS: A total of 62 patients (34 male and 28 female) with Spetzler-Martin grade 3 (n=44) and grade 4 (n=18) AVMs were examined. Thirty-seven patients were treated with a combination of microsurgery + embolization, whereas 25 patients were treated with microsurgery alone. The clinical characteristics of the treatment groups were compared (ruptured/unruptured, eloquent/non-eloquent, modified Rankin scores, duration of surgery, preoperative and postoperative hemoglobin levels, and use of blood products). RESULTS: The number of patients with ruptured or eloquently localized AVMs was more in combination of microsurgery + embolization. On the other hand, the duration, preoperative versus postoperative hemoglobin levels, and usage of blood products did not differ between treatment groups. CONCLUSION: The results of the study showed no superiority of the combined treatment in managing AVMs in parallel to recent meta-analyses. However, a patient-tailored approach is recommended while making the treatment decision for such challenging intracerebral AVM cases.