Turkish neurosurgery最新文献

{"title":"A New Measurement Technique for Lumbosacral Transitional Vertebra and Anatomic Orientation of Sacrum (Perioperative Indicator for Lumbosacral Surgery).","authors":"Cem Atabey, Ahmet Gunaydin, Ahmet Eroglu, Meltem Ozdemir, Ahmet Metin Sanli, Uygur Er","doi":"10.5137/1019-5149.JTN.49317-25.3","DOIUrl":"10.5137/1019-5149.JTN.49317-25.3","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the orientation of the sacrum, its influence on sagittal balance, and its practical relevance in identifying a sacralized L5 or lumbarized S1 as a lumbosacral transitional vertebrae (LSTV) to help prevent complications.</p><p><strong>Material and methods: </strong>Lumbosacral vertebral roentgenograms from 633 outpatients who visited our hospital between June 2018 and August 2018 were retrospectively reviewed.</p><p><strong>Results: </strong>All participants were young males with a mean age of 18.41 years (range 17-21 years). The mean ATA1 distance was 16.84 mm ± 6.28 in the 527 normal cases, 4.21 mm ± 5.32 in the 71 sacralization cases, and 21.17 mm ± 6.68 in the 35 lumbarization cases. The angle distribution among the 527 patients with normal anatomy was 10.58° ± 1.3. In the 71 patients with sacralization, the angle was 8.89° ± 1.13. Among the 35 patients with lumbarization, the angle was 9.86° ± 1.76.</p><p><strong>Conclusion: </strong>A new index formula, comprising the Anterior Translational Arch (ATA1) and Anterior Translational Angle (ATA2) is proposed. ATA1 as a distance measurement and ATA2 as an angular measurement were evaluated. These measurements can be easily obtained using either lumbosacral vertebral radiographs or sagittal MRI, owing to the simplicity of the calculation. This allows an easy identification of lumbarization and sacralization.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 3","pages":"413-419"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ernst von Bergmann and the First Neurotraumatology Book.","authors":"Ersin Haciyakupoglu, Uygur Er, Sait Naderi","doi":"10.5137/1019-5149.JTN.49096-25.1","DOIUrl":"10.5137/1019-5149.JTN.49096-25.1","url":null,"abstract":"<p><p>We aimed to introduce Ernst von Bergman, who contributed greatly to the establishment of modern neurosurgery and introduced antisepsis practices to routine use in surgery, and his important work, which is the first book on neurotrauma. The world's first book dedicated to neurotrauma, Lehre von Kopfverletzungen, written in 1880, is examined and presented together with the author's academic career. Bergmann was the first surgeon to use surgical instrument sterilization and played a pioneering role in the establishment of the antiseptic method. In addition to his valuable studies and important results on intracranial pressure changes in head trauma, the innovations and principles he brought to wound care are very important. Surgical sterilization, head trauma and the resulting increase in intracranial pressure, and his standardization of wound care make Ernst von Bergmann an important figure in the establishment of modern neurosurgery. Bergmann is the author of the first book on neurotrauma, which places him in a distinguished place in the history of neurosurgery.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finite Element Analysis of Mechanical Stress Distribution in Titanium and PEEK Rod Constructs for Isthmic L5-S1 Spondylolisthesis.","authors":"Idris Avci, Ahmed Yasin Yavuz, Ahmet Atilla Abdioglu, Kemal Paksoy","doi":"10.5137/1019-5149.JTN.49191-25.2","DOIUrl":"10.5137/1019-5149.JTN.49191-25.2","url":null,"abstract":"<p><strong>Aim: </strong>To compare the biomechanical behavior of titanium and polyetheretherketone (PEEK) rods using finite element analysis (FEA) in a Grade I L5-S1 isthmic spondylolisthesis model.</p><p><strong>Material and methods: </strong>An anatomically accurate 3D finite element model of the L3?S1 spine was created from CT data of a healthy 30-year-old male. A unilateral pars defect at L5 simulated Grade I spondylolisthesis. Instrumented models with titanium and PEEK rods were subjected to five physiological loading conditions. Von Mises stresses and displacement vectors were analyzed and stress distributions on bone, screws and rods were measured.</p><p><strong>Results: </strong>Titanium rods absorbed significantly higher loads across all loading conditions (e.g., 117 N vs. 34.5 N in compression; p < 0.01), while PEEK constructs allowed greater load sharing with the bone. Screws in titanium systems experienced higher stresses, particularly in posterior shear and axial rotation. Both materials effectively reduced stress at the pars defect.</p><p><strong>Conclusion: </strong>Titanium constructs offer high rigidity but concentrate stress on implants, potentially increasing complication risk. PEEK rods demonstrated a more physiological load distribution, reducing implant stress without compromising stability. PEEK rods may serve as a biomechanically advantageous alternative to titanium in select spondylolisthesis cases. Further clinical validation is warranted.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"246-253"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Subdural Hematoma: Evaluation of Predictive Factors and Efficacy of Various Surgical Approaches on Prognosis.","authors":"Hasan Idiz, Nafis Vural, Elif Ertas, Hasan Can Guven, Murat Duyan, Ahmet Sukru Alparslan","doi":"10.5137/1019-5149.JTN.48038-24.3","DOIUrl":"10.5137/1019-5149.JTN.48038-24.3","url":null,"abstract":"<p><strong>Aim: </strong>To examine the parameters influencing prognosis, and the effectiveness of surgical techniques in patients aged over 65 years with acute subdural hematoma (ASH).</p><p><strong>Material and methods: </strong>From 2017 to 2023, a retrospective evaluation was conducted on 62 individuals admitted to the emergency department, diagnosed with ASH, and who underwent had surgical interventions. Demographic data, Glasgow Coma Scale (GCS) score upon admission, radiological findings including hematoma volume, midline shift, and surgical techniques used (craniotomy, craniectomy), were examined. The impact of each predictive factor on prognosis was investigated.</p><p><strong>Results: </strong>The average patient age was 73.67 ± 10.00 years (range: 65 to 101 years). The mean GCS score at presentation was 9.00 ± 4.44. The average subdural hematoma volume was 62.2 ± 36.5 mL, and the average midline shift was 9.4 ± 7.7 mm. A significant positive correlation existed between the admission GCS score and the Glasgow Outcome Scale (GOS) score (? = 0.684, p < 0.001). Surgeries comprised 83.3% craniotomy, 11.9% craniectomy, and 4.8% extended craniectomy. The overall mortality rate was 19%. The rate of favorable clinical outcomes (GOS 4?5) was 31% in the craniotomy cohort and 18% in the craniectomy cohort (p=0.042).</p><p><strong>Conclusion: </strong>Age, GCS score at presentation, hematoma volume, and midline displacement were significant factors influencing the prognosis in geriatric ASH patients. Patients who underwent craniotomy exhibited superior functional outcomes to those who underwent craniectomy (p=0.042). Surgeries conducted within an average of 3.4 ± 0.6 hours, along with treatment strategies tailored to individual clinical evaluations, appeared to enhance the prognosis.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"302-309"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Glioblastoma with Turcot Syndrome.","authors":"Zhuohua Fu, Gang Deng, Jie Zhang, Qibin Song, Baohui Liu, Zhou Xu, Huihua He, Na Zhan, Huangqing Ouyang, Qianxue Chen, Weiguo Hu","doi":"10.5137/1019-5149.JTN.48237-24.2","DOIUrl":"10.5137/1019-5149.JTN.48237-24.2","url":null,"abstract":"<p><p>Turcot syndrome (TS) is an extremely rare genetic disorder characterized by the concurrent occurrence of primary brain tumors and colorectal cancer. The prognosis for patients with TS is typically poor. A 57-year-old man with TS who developed recurrent glioblastoma and had a family history of colon cancer is reported. In 2022, the patient underwent robot-assisted stereotactic surgery for the resection of a central nervous system (CNS) tumor. Molecular genetic analysis identified microsatellite instability in the DNA mismatch repair (MMR) gene, confirming the diagnosis of TS. Additional mutations in the ATM and TP53 genes were also detected, which are rarely associated with TS. Despite treatment with the Stupp regimen, the patient experienced acute neurological deterioration, ultimately resulting in death 15 months after the onset of symptoms. Molecular diagnostics play a crucial role in guiding appropriate care and management for patients with TS. Early diagnosis, genetic testing, and preventive measures are essential for the effective management of this condition.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 1","pages":"168-174"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent and De Novo Internal Carotid Artery Aneurysms with Severe Stenosis Following Radiation Therapy for Nasopharyngeal Carcinoma: A Rare Case Report.","authors":"Xiaohui Xu, Yongjun Tao, Lingling Qiu","doi":"10.5137/1019-5149.JTN.49391-25.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.49391-25.2","url":null,"abstract":"<p><strong>Abstract: </strong>Rapid formation and recurrence of aneurysms accompanied by severe arterial stenosis following radiation therapy (RT) for nasopharyngeal carcinoma (NPC) is an uncommon clinical phenomenon. We present the case of a 51-year-old man who developed subarachnoid hemorrhage years after undergoing RT for NPC. Digital subtraction angiography revealed a ruptured, irregular, wide- neck aneurysm at the posterior communicating segment of the right internal carotid artery (ICA), along with significant stenosis (approximately 80%) at the cervical segment of the same artery. The cervical ICA stenosis was initially treated with stenting, followed by LVIS stent-assisted coil embolization of the aneurysm. Over the next four years, the patient developed three entirely new ICA aneurysms-one of which arose from within the middle portion of the previously placed LVIS stent (a finding not previously reported)-as well as one recurrent aneurysm. This rare case highlights the dynamic nature of RT-induced ICA aneurysm formation and recurrence. Lifelong monitoring and individualized endovascular management are crucial. Considering the fragility of irradiated tissues, extensive arterial involvement, and increased surgical risk from repeat procedures, endovascular treatment was favored over open surgery.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 4","pages":"608-614"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Mean Arterial Pressure: Critical Nuances in Hemodynamic Targeting for Severe Traumatic Brain Injury.","authors":"Olukorede Olabanji Adekunle","doi":"10.5137/1019-5149.JTN.50778-26.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.50778-26.2","url":null,"abstract":"","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 4","pages":"627-628"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Caudal Epidural Pethidine on Pain Control and Early Mobilization after Posterior Spinal Instrumentation: A Randomized Controlled Trial.","authors":"Necati Kaplan, Ilke Tamdogan, Tamer Tamdogan, Sevim Ondul, Numan Karaarslan, Ibrahim Yilmaz","doi":"10.5137/1019-5149.JTN.48568-25.3","DOIUrl":"10.5137/1019-5149.JTN.48568-25.3","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effects of administering pethidine (also known as meperidine), a long-acting narcotic analgesic, via the caudal epidural route at the conclusion of posterior lumbar instrumentation (PLI) surgery on postoperative pain control, and early mobilization of patients.</p><p><strong>Material and methods: </strong>The cases included in this prospective study (n=48) were randomly divided into two groups, ensuring similar gender and age distributions and uniformity regarding lumbar pathologies requiring surgery. In the first group, 20 mL of sodium chloride (0.09%) solution containing pethidine chloride (0.5 mg/kg) was administered via a caudal epidural block before the patients were awakened from anesthesia. The control group consisted of cases in which the caudal epidural block was not performed using pethidine or any other pharmaceutical/pharmacological agent. Visual analog scale (VAS) pain assessments were performed in both groups preoperatively, postoperatively, and 24, 48, and 72 hours after awakening and recovery. Oral feeding at the sixth postoperative hour and mobilization at the eighth postoperative hour were evaluated in all cases. The data obtained were statistically analyzed with a significance level of ?=0.05.</p><p><strong>Results: </strong>The VAS scores of cases administered with pethidine via a caudal block were found to be significantly lower at all measurement times compared with those without a caudal epidural block (p < 0.05). The need for analgesic medication in terms of dosage and duration was lower in the pethidine group during the postoperative period. Both groups began oral feeding at the sixth postoperative hour. The cases in the pethidine group were mobilized with ease at the eighth postoperative hour, whereas those without a caudal epidural block with pethidine could only be mobilized as early as the 24th postoperative hour.</p><p><strong>Conclusion: </strong>Administering pethidine via a caudal epidural block before awakening at the conclusion of PLI surgery may provide benefits in postoperative pain control and early mobilization.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"254-263"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Landmarks and Boundaries of the Endoscopic Sublabial Transmaxillary Approach to the Middle Cranial Fossa: A Cadaveric Study.","authors":"Ebubekir Akpinar, Aysu Iyigun Kabakci, Hasan Cagrı Postuk, Ercan Bosnak, Akin Akakin, Abuzer Gungor, Turker Kilic, Bekir Tugcu","doi":"10.5137/1019-5149.JTN.49296-26.4","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.49296-26.4","url":null,"abstract":"<p><strong>Abstract: </strong>AIM: To demonstrate the anatomical framework of the endoscopic sublabial transmaxillary approach (ESTA) to the middle cranial fossa (MCF). MATERIAL and METHODS: Six formalin-fixed human cadaveric heads injected with red and blue silicone were used for endoscopic dissections to define the surgical landmarks and anatomical limits of the ESTA. Images were obtained using a 4K high-definition camera, microscope, and video endoscopy systems. RESULTS: Accessing the MCF via the ESTA involves sublabial mucosal dissection; drilling of the anterior wall of the maxillary sinus; removal of the maxillary sinus mucosa while preserving the infraorbital nerve (ION); opening of the posterior wall of the maxillary sinus, with the ION serving as the medial limit; drilling of the lateral pterygoid process; mobilization and retraction of the superior head of the lateral pterygoid muscle and the temporalis muscle; identification of the foramen rotundum (FR) and foramen ovale (FO), followed by the maxillary and mandibular nerves; drilling of the sphenoid bone, limited medially by the vertical line extending from the FR and inferiorly by the horizontal line extending from the FR; and entry into the temporal pole following dural opening. The ESTA provided a statistically significantly shorter distance to the MCF than the endonasal transmaxillary approach (EETA, p < 0.001). CONCLUSION: The MCF can be accessed through the ESTA while preserving the surrounding neurovascular structures. This approach provides direct access to the temporal pole without the need for craniotomy or brain parenchymal retraction and may serve as an alternative to conventional transcranial approaches.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 5","pages":"722-733"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral Biportal Endoscopy for Lumbar Disc Herniation and Spinal Stenosis: Clinical Outcomes and Complication Analysis.","authors":"Ali Kaplan, Mehmet Ilker Ozer, Nurullah Buyukgul, Ilker Solmaz","doi":"10.5137/1019-5149.JTN.50151-25.4","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.50151-25.4","url":null,"abstract":"<p><strong>Abstract: </strong>AIM: To evaluate clinical outcomes, complications, and pathological distribution in patients with lumbar disc herniation (LDH) and/or lumbar spinal stenosis (LSS) undergoing unilateral biportal endoscopic (UBE) surgery. MATERIAL and METHODS: This retrospective study included 127 patients with LDH and/or LSS who underwent UBE surgery between October 2024 and May 2025. Demographic and operative data were reviewed. Clinical outcomes were evaluated using Visual Analog Scale (VAS) scores at baseline, on postoperative Day 1, and at three months, and by using Oswestry Disability Index (ODI) scores at baseline and at three months. The primary outcome was the change in ODI from baseline to three months. Secondary outcomes included trajectories of VAS-leg/back, operative metrics, and complications. RESULTS: Of the patients, 58.3% were female and 41.7% were male with a mean age of 49.20±13.92 years. The mean operative time was 48.76±14.18 min, and 94.5% were discharged within one day. The most common pathology was pure disc herniation (63%), predominantly at the L4-L5 level (59.8%). Complication rates were as follow: dural tear in 3.9%, wound discharge in 2.4%, and recurrence in 3.2%. Statistically significant improvements in VAS and ODI scores were observed postoperatively (p.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"36 5","pages":"701-709"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}