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Öğe Correlation of Cervical Spinal Degeneration with Rise in Smartphone Usage Time in Young Adults(WOLTERS KLUWER MEDKNOW PUBLICATIONS, WOLTERS KLUWER INDIA PVT LTD, A-202, 2ND FLR, QUBE, C T S NO 1498A-2 VILLAGE MAROL, ANDHERI EAST, MUMBAI, Maharashtra 400059, INDIA, 2020) Çevik, Serdar; Kaplan, A.; Katar, SalimAims: The study aimed to define the association between spinal degeneration parameters and the rise in smartphone usage time. This was a cross?sectional study. Subjects and Methods: Young adults aged 20–35 years, who presented to our outpatient clinic due to neck pain between 2016 and 2018, were examined. Cervical disc degeneration, disc placement, Modic changes, and sagittal balance were retrospectively measured using magnetic resonance imaging (MRI) in 107 relatively patients. Data about daily phone usage times of the participants were obtained by a questionnaire filled in at the time of admission. Results: The total number of disc distances analyzed was 535 (Group 1; n = 200, Group 2; 335). In Group 1, the disc displacement was present in 30%, and in Group 2, the disc displacement was present in 35%. In terms of DD severity, the total DD score was >10 in 18 (18/40; 45%) patients in Group 1, and in 39 patients (39/67; 58%) in Group 2. The mean Cobb angle of Group 1 was 10.3° ± 6.57° (range, 2° to 34°), and that of Group 2 was 7.6° ± 5.14° (range, 1° to 26°) (Pcobb = 0.048). Modic changes were detected in 17 of the 107 patients (15.8%). Of the 17 patients, 3 (3/40, %7.5) were Group 1 and 14 (14/67, %20.9) were Group 2. MC was detected in 4 vertebrae in Group 1, and 24 vertebrae in Group 2 (P = 0.001) Conclusions: The analysis of cervical spine MRI data of young adult patients with neck pain shows that the smartphone usage time is effective in cervical sagittal balance disruption, disc degeneration, and development of Modic changes.Öğe The Effectiveness of the Amount of Polymethylmethacrylate Used in the Treatment of Lumbar Osteoporotic Compression Fractures(GALENOS PUBL HOUSE, Kaçamak Sokak 21/1, ISTANBUL, Fındıkzade 34093, TURKEY, 2020) Yüksel, Mehmet Onur; Çevik, Serdar; Erdoğan, Barış; Katar, Salim; Tunçkale, Tamer; Çalışkan, Tezcan; Ervan, ŞevketObjective: We aimed to investigate the effectiveness of the amount of polymethylmethacrylate used in pain control and maintenance of long-term vertebra corpus height in patients undergoing percutaneous vertebroplasty due to osteoporotic compression fracture of the lumbar vertebra. Method: A total of 60 patients who underwent unilateral percutaneous vertebroplasty between 2014 and 2019 due to osteoporotic compression fracture of the lumbar vertebrae were included in the study. Patients who received 5 ml and 3 ml cement injection were retrospectively analyzed. Of patients, postoperative visual analogue scale (VAS) score and anterior vertebral height of the patients at 1st-year control were evaluated. Results: In the postoperative period, the mean visual analogue scale score was 2.3±0.46 in the 5 ml injected group and 2.2±0.4 in the 3 ml injected group (p5 ml=0.001, p3 ml= 0.001). There was a statistically significant decline in pain control in both groups. The mean anterior vertebral height loss (AVHL) in the 5 ml injected group was 31.5±0.40%, and 32.6±0.47% in the 3 ml injected group (p5 ml=0.820, p3ml= 0.870). There was no statistically significant alteration in both groups. Conclusion: Our results indicate that the 3 ml polymethylmethacrylate injection during the percutaneous vertebroplasty procedure provides adequate pain control and stabilization in patients with lumbar vertebral osteoporotic fracture. Therefore we think that small amount of polymethylmethacrylate (3 ml) is sufficient to avoid undesirable complications in this patient group.Öğe Relationship Between Degeneration or Sagittal Balance With Modic Changes in the Cervical Spine(CUREUS INC, PO BOX 61002, PALO ALTO, CA 94306, 2021) Kitiş, Serkan; Çevik, Serdar; Kaplan, Atilla; Yılmaz, Hakan; Katar, Salim; Cömert, Serhat; Ünsal, ÜlkünObjective: This study evaluates the relationship between degenerative and Modic changes (MCs) in the cervical spine and compares the results with the cervical sagittal balance parameters. Methods: We retrospectively reviewed 275 patients with neck pain who applied to our outpatient clinic and underwent cervical magnetic resonance imaging (MRI) and cervical anteroposterior (AP)/lateral (Lat) X-ray radiography between January 2016 and January 2018. The clinics, demographic information, and radiological findings of the patients were examined. Modic changes, disc degeneration, and facet degeneration (FD) were examined by cervical MRI, and T1 slope and Cobb angle were measured by cervical AP/Lat X-ray radiography. These results were compared to evaluate their relations with each other. Results: No relationship between the presence or absence of degenerative changes (Modic changes, facet degeneration, and disc degeneration) and sagittal balance parameters (T1 slope and Cobb angle) was found. However, when each cervical segment was examined separately, facet degeneration at the C4-C5 level and Modic changes at the C3-C4, C4-C5, and C6-C7 levels were statistically significant with the Cobb angles, and the Modic changes at the C3-C4 level and disc degeneration at the C2-C3 level were found to be significant with T1 slope values. Conclusions: Our findings indicate that MCs increased with decreased cervical curvature, increasing disc and facet degeneration, although the causal mechanisms are not clear.Öğe The Synergistic Effect of Combined Transforaminal and Caudal Epidural Steroid Injection in Recurrent Lumbar Disc Herniations(CUREUS INC, PO BOX 61002, PALO ALTO, CA 94306, 2021) Evran, Şevket; Kayhan, Ahmet; Baran, Oğuz; Saygı, Tahsin; Katar, Salim; Akkaya, Enes; Özbek, Muhammet Arif; Çevik, SerdarBackground: Recurrent lumbar disc herniation (RLDH) is one of the most common causes of chronic low back and leg pain. Although surgical treatment has high success rates in primary lumbar disc herniations, recurrence is not an uncommon clinic condition after the surgery. Considering the recurrent surgeries have lower success rates and higher risks, such as dural tear and nerve injury, alternative treatment modalities are needed for RLDH patients. Epidural steroid injections (ESI), particularly transforaminal steroid injection (TFESI) and caudal steroid injection (CESI), which are the alternative treatments to surgery, have not shown reasonable results in RLDH separately. In this study, we aimed to investigate the effects of combined TFESI and CESI (TFESI + CESI) treatment, which has been found successful in primary lumbar disc herniation (PLDH) and on pain control and quality of life in RLDH patients for the first time. Materials and methods: A total of 71 patients, who had ESI treatment as only TFESI or TFESI + CESI because of RLDH in our clinic between March 2017 and February 2020, were investigated retrospectively. The visual analog scale (VAS) leg, VAS back, and Oswestry disability index (ODI) were used to assess leg pain, low back pain, and limitation of daily routine activities. Each assessment was done before the intervention and repeated at the third week, the third month, and the sixth month of injection, and the results were noted. Results: Out of 71 patients, 38 were female and 33 male. Patients were divided into two subgroups according to the applied ESI methods as only TFESI (n = 32) and TFESI + CESI (n = 39). In the only TFESI group, the mean VAS leg score was 7.84, 4.63, 5.40, and 6.19 before, at the third week, the third month, and the sixth month of the injection, respectively. Also, in this group, the mean VAS back score was 8.06, 4.16, 4.88, and 5.97; the mean ODI score was 55.81, 34.31, 37.5, and 49.04 in the same respect. In the TFESI + CESI group, the mean VAS leg score was 8.20, 2.87, 3.64, 4.23; mean VAS back score 8.03, 3.05, 3.90, 4.08; mean ODI score 56.56, 28.05, 30.21, 33.64 before, at the third week, third month, and sixth month of the injection, respectively. The mean of the initial VAS leg, VAS back, and ODI scores was not found to be statistically significantly different between the two groups. The mean of all VAS leg, VAS back, and ODI scores was found to be lower in the TFESI + CESI group than the only TFESI group at each third-week, third-month, and sixth-month controls, and these differences were statistically significant. (p<0.0001 at each controls for VAS leg; p = 0.001 at third week, p = 0.002 at third month and p <0.0001 at sixth month for VAS back; p= 0.0003 at third week, p<0.0001 at third month, p<0.0001 at sixth month for ODI) Conclusion: Our study demonstrates that TFESI + CESI treatment is an effective non-surgical treatment for RLDH. Considering the higher risks and lower success rates of recurrent surgeries, TFESI + CESI can be a potential treatment option for RLDH patients.Öğe Thymoquinone ameliorates delayed cerebral injury and cerebral vasospasm secondary to experimental subarachnoid haemorrhage(VIA MEDICA, UL SWIETOKRZYSKA 73, 80-180 GDANSK, POLAND, 2020) Akkaya, Enes; Evran, Şevket; Çalış, Fatih; Çevik, Serdar; Katar, Salim; Karataş, Ersin; Koçyiğit, Abdurrahim; Sağlam, Mustafa Yasin; Hatiboğlu, Mustafa Aziz; Hanımoğlu, Hakan; Kaynar, Mehmet YaşarAim of the study. Among subarachnoid haemorrhage (SAH) patients, delayed cerebral injury (DCI) and infarction are the most important causes of death and major disability. Cerebral vasospasm (cVS) and DCI remain the major cause of death and disability. Thymoquinone (TQ) is the substance most responsible for the biological activity of nigella sativa (NS) and is useful in the treatment of ischaemic and neurodegenerative diseases, oxidative stress, inflammatory events, cardiovascular and neurological diseases. We conducted an experimental study aimed to investigate the preventive and corrective effects of TQ. Materials and methods. 24 Sprague-Dawley rats were randomly divided into three groups. The first was the control group which was a sham surgery group. The second group was the SAH group where the double haemorrage SAH protocol was used to induce vasospasm. The third group was the SAH+TQ group, where cVS was induced by the SAH protocol and the animals received oral 2 cc thymoquinone solution for seven days at a dose of 10 mg/kg, after the induction of SAH. The rats were euthanised seven days after the first procedure. The degree of cerebral vasospasm was evaluated by measuring the basilar artery luminal area and arterial wall thickness. Apoptosis was measured by the western blot method at brainstem neural tissue. Oxidative stress was measured by the Erel Method. Endothelin-1 was measured with ELISA analysis at blood. Statistical analysis was performed. Results. Endothelin-1 values were found to be statistically significantly lower in the control and SAH+TQ groups compared to the SAH group (P < 0.001). Mean lumen area values were significantly higher in the control and SAH+TQ groups than in the SAH group (P < 0.001). In the control and SAH+TQ groups, wall thickness values decreased significantly compared to the SAH group (P < 0.001). OSI values were significantly lower in the control and SAH+TQ groups than in the SAH group (P < 0.001). Apoptosis was significantly lower in the control and SAH+TQ groups than in the SAH group (P < 0.001). Conclusion. Our results show that post-SAH TQ inhibits/improves DCI and cVS with positive effects on oxidative stress, apoptosis, ET-1, lumen area, and vessel wall thickness, probably due to its anti-ischaemic, antispasmodic, antioxidant, anti- -inflammatory, anti-apoptotic and neuroprotective effects.Öğe Tissue Thiol Concentration in High-Grade Gliomas: Is There any Association Between IDH1 Mutation Presence and Tumoral Cellular Antioxidant Defense?(Turkish Neurosurgical Soc, 2021) Evran, Sevket; Kayhan, Ahmet; Baran, Oguz; Cevik, Serdar; Katar, Salim; Kaya, Mustafa; Sonmez, DeryaAIM: To assess and compare the antioxidant capacities of high-grade gliomas (HGG) according to their grades and the presence of isocitrate dehydrogenase 1 (IDH1) mutation using tissue thiol level measurement. MATERIAL and METHODS: Tissue thiol concentrations were measured in 41 HGG samples and 21 healthy brain tissues obtained from autopsy procedures, which were performed within the first 4 hours of death. All samples were stored at -80 degrees C, and a thiol quantification kit was used in evaluating tissue thiol levels. The Number Cruncher Statistical System was used for statistical analyses to detect the differences between the control group and the HGG group, which was also divided into subgroups according to their grade and IDH1 mutation presence. RESULTS: The tissue thiol levels of HGGs were found to be higher than the control group (p=0.001). Although the median thiol levels of Grade 4 gliomas were higher than those of Grade 3, no statistically significant difference was noted (p=0.076). When all tumors were compared according to the IDH1 mutation presence, IDH1-negative (IDH1-) HGGs had higher thiol contents than IDH1 mutant (IDH1+) HGGs (p=0.001). The thiol levels of Grade 4 IDH1- gliomas were statistically significantly higher than of Grade 3 gliomas (p=0.023), but no statistically significant difference between the thiol levels of Grade 3 and Grade 4 IDH1+ tumors was noted (p=0.459). CONCLUSION: We have demonstrated the higher thiol concentrations of HGGs, particularly IDH1- ones. The sulfhydryl contents of gliomas as an indicator of tumoral antioxidant capacity may be responsible for the treatment resistance of IDH1- gliomas, the mechanism of which is not clear. Thiols can be a novel target for treatment, considering the unsatisfactory results of current modalities for HGGs.Öğe The Use of Rotterdam CT Score for Prediction of Outcomes in Pediatric Traumatic Brain Injury Patients Admitted to Emergency Service(Karger, 2020) Katar, Salim; Aydin Ozturk, Pinar; Ozel, Mehmet; Arac, Songul; Evran, Sevket; Cevik, Serdar; Baran, OguzIntroduction: Rotterdam CT score for prediction of outcome in traumatic brain injury is widely used for patient evaluation. The data on the assessment of pediatric traumatic brain injury patients with the Rotterdam scale in our country are still limited. In this study, we aimed to evaluate the use of the Rotterdam scale on pediatric trauma patients in our country and assess its relationship with lesion type, location and severity, trauma type, and need for surgery. Methods: A total of 229 pediatric patients admitted to the emergency service due to head trauma were included in our study. Patients were evaluated in terms of age, gender, Glasgow Coma Scale (GCS), initial and follow-up Rotterdam scale scores, length of stay, presence of other traumas, seizures, antiepileptic drug use, need for surgical necessity, and final outcome. Results: A total of 229 patients were included in the study, and the mean age of the patients was 95.8 months. Of the patients, 87 (38%) were girls and 142 (62%) were boys. Regarding GCS at the time of admission, 59% (n = 135) of the patients had mild (GCS = 13-15), 30.6% (n = 70) had moderate (GCS = 9-12), and 10.5% (n = 24) had severe (GCS < 9) head trauma. The mean Rotterdam scale score was calculated as 1.51 (ranging from 1 to 3) for mild, 2.22 (ranging from 1 to 4) for moderate, and 4.33 (ranging from 2 to 6) for severe head trauma patients. Rotterdam scale score increases significantly as the degree of head injury increases (p < 0.001). Discussion: With the adequate use of GCS and cerebral computed tomography imaging, pediatric patients with a higher risk of mortality and need for surgery can be predicted. We recommend the follow-up of pediatric traumatic brain injury patients with repeated CT scans to observe alterations in Rotterdam CT scores, which may be predictive for the need for surgery and intensive care.
