Turkish neurosurgery最新文献

{"title":"Does Hybrid Instrumentation Using Sublaminar Bands Give Comparable Results to All Pedicle Screw Constructs in Surgical Correction of Adolescent Idiopathic Scoliosis? A Systematic Review and Meta-Analysis of Current Evidence.","authors":"Vishal Kumar, Arvind J Vatkar, Dr Vikash Raj, Sitanshu Barik, Richa Richa","doi":"10.5137/1019-5149.JTN.46366-24.3","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.46366-24.3","url":null,"abstract":"<p><strong>Aim: </strong>To compare the results of surgical correction of adolescent idiopathic scoliosis (AIS) by posterior instrumentation using the conventional all pedicle screw fixation method (PS) and the hybrid fixation method utilising the sublaminar bands along with pedicle screws (HG).</p><p><strong>Material and methods: </strong>The study adheres to Preferred Reporting Items for Systematic reviews and Meta Analysis (PRISMA) and was registered with PROSPERO. This review included studies conducted on patients having AIS. All studies comparing the outcomes of PS with HG were included.</p><p><strong>Results: </strong>We found an improvement of the main curve (p=0.007; SMD (IV, Random) = 0.54; 95% CI [0.15, 0.93]) in the PS group to be statistically significant. The two groups had statistically insignificant differences in the operative time, blood loss, number of levels fused, secondary curve correction and complication rates. We found PS had better outcomes in cases with preoperative hyperkyphosis whereas HG was better for patients with preoperative hypokyphosis. The complications on ling term follow up in the form of distal junctional kyphosis 2 years after surgery is higher in PS (5%).</p><p><strong>Conclusion: </strong>Hybrid constructs using sublaminar bands along with pedicle screws are safe and effective option for posterior instrumentation of AIS due to reduced incidence of complications like distal junctional kyphosis. They give better deformity correction in sagittal planes hence are more effective in restoring the dorsal kyphosis post-operatively.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 2","pages":"189-201"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702594","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":"Perspectives of Turkish Neurosurgeons on Concussion/Mild Traumatic Brain Injury: A National Survey.","authors":"Serkan Civlan, Batuhan Bakirarar, Caghan Tonge, Cagri Elbir, Emrah Egemen, Umit Akin Dere, Baris Albuz, Mehmet Erhan Turkoglu, Mehmet Erdal Coskun, Fatih Yakar","doi":"10.5137/1019-5149.JTN.46658-24.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.46658-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the adherence to and awareness of current concussion/mild traumatic brain injury (mTBI) guidelines among Turkish neurosurgeons.</p><p><strong>Material and methods: </strong>A cross-sectional electronic survey was administered to all members of the Turkish Neurosurgical Society (n=1875 neurosurgeons) between January and February 2024. The 208 respondents (11.1%) were categorized based on years of neurosurgery specialization, type of current institution, residency program accreditation, and current institution accreditation.</p><p><strong>Results: </strong>The majority of the participants (66.3%) were employed in Tertiary-level Healthcare (TLH) institutions. In TLH settings, Emergency Medicine Practitioners (EMPs) were primarily responsible for the initial computed tomography (CT) scan for pediatric patients, while this decision was also made by EMPs for adult patients, regardless of years of experience in neurosurgery specialization. Participants enrolled in residencies at accredited institutions were more likely to obtain detailed patient histories. The rates of adherence to current guidelines were comparable across institutions, regardless of their accreditation status.</p><p><strong>Conclusion: </strong>This pioneering study evaluating neurosurgeons? adherence to and awareness of concussion/mTBI guidelines revealed a uniformity in compliance among Turkish practitioners, irrespective of years of experience, institutional type, or accreditation status.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 2","pages":"237-250"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702600","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":"Erdheim-Chester Disease with Calvarial Involvement: A Rare Case of Histiocytosis.","authors":"Osman Boyali, Furkan Diren","doi":"10.5137/1019-5149.JTN.44217-23.5","DOIUrl":"10.5137/1019-5149.JTN.44217-23.5","url":null,"abstract":"<p><p>Erdheim-Chester Disease is a rare systemic xanthogranulomatous infiltrating disease, characterized by lipid-laden histiocytes accumulating in various organs and almost always in bones. Etiology of the disease is still unknown. It may involve various organs and systems, such as musculoskeletal, cardiac, pulmonary, renal, gastrointestinal and central nervous system (CNS) as well as the skin. The most common systemic manifestations are bone lesions and the specific sign of these are bilateral sclerosis of the diaphysis and metaphysis of long bones. Symptoms and signs can vary related to the organ or system that is involved. In CNS involvement, cerebellar and pyramidal symptoms and signs are the most common, while headache, seizure, cranial nerve paralysis, neuropsychiatric along with cognitive complaints and mood disorders are also reported. Furthermore, there are asymptomatic cases. Histologically lipid-laden foamy histiocytes with small round nucleuses and without nuclear grooves are the characteristic histological features. These histiocytes show positive CD68 and negative S100 and CD1a immunoreaction. Surgery is a reasonable treatment in the patients who have extra- or intracranial lesions with smooth borders when the neurological signs and symptoms are mild. Medical treatment of the disease includes steroid, cytotoxic agents such as cladribin, IFN α-2a, recombinant human interleukin-1 receptor antagonist, tirosine kinase inhibitors, biphosphonate and autologue hematopoetic stem cell transplantation. In this report a 29 years old man was presented with a frontal calvarial lesion who was operated and diagnosed as Erdheim Chester disease.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"182-188"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019312","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":"Relationship Between Defect Volume and Comorbid Pathologies in Patients Undergoing Surgery for Myelomeningocele.","authors":"Zeliha Culcu Gurcan, Haydar Celik, Yavuz Erdem, Ayhan Tekiner, Dilek Kahveciogullari, Berkay Ayhan, Burak Yuruk, Serdar Cengiz, Kemal Kantarci, Tuncer Tascioglu, Mehmet Emre Yildirim, Hakan Gurcan, Omer Sahin","doi":"10.5137/1019-5149.JTN.46011-23.3","DOIUrl":"10.5137/1019-5149.JTN.46011-23.3","url":null,"abstract":"<p><strong>Aim: </strong>To determine sac volume based on radiological examinations in patients undergoing surgery for myelomeningocele (MMC) and to investigate the relationship of sac volume with hydrocephalus and Chiari malformation type 2 (CM) with a view to determining the optimum length of follow-up and recommend a treatment plan.</p><p><strong>Material and methods: </strong>The present study involved the retrospective review of radiologic examinations and medical files of 81 patients who underwent surgery for myelomeningocele between 2015 and 2022 in the neurosurgery clinic of Ankara Training and Research Hospital. Then, MMC sac volumes were measured and the statistical relationship of these measurements with the Evans Index, progressive enlargement of the ventricles after sac repair and CM was investigated.</p><p><strong>Results: </strong>Of the 81 patients, 41 (50.6%) were boys and 40 (49.4%) were girls. The median MMC sac volume was 11,005.28 mm³ and the mean Evans index (EI) based on brain tomography performed on postnatal day1was 0.405 ± 0.146. Analysis of the relationship between the EI and MMC sac volume yielded r=0.622, p < 0.001 and showed a strong positive correlation between the two parameters at a statistical significance level of 5%. Evans Indexes based on brain tomography scans performed on postnatal day 1 showed that ventriculomegaly was present in 49 (60.5%) patients and absent in 32 (39.5%) patients. In patients who developed hydrocephalus after sac repair, there was no correlation between the day of intervention and sac volume. Mean sac volume was 28,297.36 mm³ in 28 patients with comorbid CM versus 7,600.32 mm³ in patients without CM. All children with CM required shunting.</p><p><strong>Conclusion: </strong>Patients with larger myelomeningocele sac volume have higher risk of concomitant hydrocephalus or subsequent development of hydrocephalus after sac repair compared to patients with a smaller sac volume. These patients should definitely be evaluated for same-session intervention. Patients with a larger sac volume and/or comorbid CM should be followed up more frequently and for a longer period of time.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"90-94"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019392","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":"Clinicopathological and Prognostic Significance of Tim-3 and Rel-B Expressions in Grade 4 Diffuse Gliomas.","authors":"Fatih Yilmaz, Evrim Yilmaz, Deniz Arik, Funda Canaz, Bulent Yildiz, Melek Akcay, Emre Ozkara, Cengiz Bal","doi":"10.5137/1019-5149.JTN.43568-23.2","DOIUrl":"10.5137/1019-5149.JTN.43568-23.2","url":null,"abstract":"<p><strong>Aim: </strong>To assess the clinicopathological and prognostic significance of Tim-3, an immune checkpoint molecule, and Rel-B, an NF-?B subunit, in grade 4 diffuse glioma samples and their relationship with each other.</p><p><strong>Material and methods: </strong>The demographic, radiologic, treatment, and prognostic data of patients diagnosed with grade 4 diffuse glioma between 2016 and 2019 were reviewed and recorded. Tim-3 and Rel-B were applied to the paraffin-embedded tissues by immunohistochemistry method. Tim-3 expression was grouped as immunoreactivity density score (IDS) (Low, High) and expression percentage ( < 12%, > 12%), while Rel-B expression was divided into positive and negative groups.</p><p><strong>Results: </strong>Ninety-nine grade 4 diffuse glioma samples were detected, 8 of which were IDH-1 positive. Tim-3 was expressed only in immune cells around and inside the tumoral tissue, and expression was detected only in tumoral cells with Rel-B. Tim-3 IDS was found at lower levels (median 31.8) in IDH-1 positive cases and higher (median 158) in IDH-1 negative ones (p=0.020). A significant correlation was found between the Tim-3 IDS high group and Rel-B positivity (p=0.007). In the IDH-1 negative cohort, the univariate analysis revealed higher Tim-3 expression percentage and higher IDS were associated with better overall survival (OS) (p=0.041 and p=0.042 respectively) and progression-free survival (PFS) (p=0.023 and p=0.029 respectively), while in the multivariate analysis higher Tim-3 expression percentage was found to be an independent predictor for better OS (p=0.008) and PFS (p=0.022). Rel-B positive cases exhibited longer OS and PFS but the result was not statistically significant (p > 0.05).</p><p><strong>Conclusion: </strong>Tim-3 can be a good prognostic predictor and treatment candidate, especially in patients with IDH-1 negative grade 4 diffuse gliomas however, further studies with more cases are needed for Rel-B. The significant relationship between Tim-3 and Rel-B expressions supported the interaction between NF-?B and immune checkpoint pathways.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"22-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018621","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":"Correlations of the Laminectomy Width and C5 Palsy After Open-Door Cervical Laminoplasty.","authors":"Kazuma Doi, Toshiyuki Okazaki, Kazunori Shibamoto, Satoshi Tani, Junichi Mizuno","doi":"10.5137/1019-5149.JTN.46768-24.3","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.46768-24.3","url":null,"abstract":"<p><strong>Aim: </strong>To examine the risk factors for postoperative C5 palsy, particularly an association between the laminectomy width and C5 palsy after open-door cervical laminoplasty (CLP).</p><p><strong>Material and methods: </strong>This single-center study analyzed data from 132 adult patients who underwent open-door CLP for degenerative diseases. C5 palsy developed in 8 (6.1%) patients, although seven of them made a full recovery. The demographic and radiographic findings of the C5 palsy group were compared with those of the non-C5 palsy group.</p><p><strong>Results: </strong>The laminectomy width did not correlate with the incidence of C5 palsy (C5 palsy group, 19.39 ± 1.86 mm; non-C5 palsy group, 20.77 ± 2.61 mm, p > 0.05). The preoperative T2-high lesion in the spinal cord on magnetic resonance imaging was present in 62.5% of the patients in the C5 palsy group, whereas it was positive in 20.3% in the non-C5 palsy group (p = 0.021). The mean C4/5 foraminal minimal distances on the open side were 2.42 and 3.58 mm in the C5 and non-C5 palsy groups, respectively (p = 0.001). These variables might be risk factors for C5 palsy.</p><p><strong>Conclusion: </strong>The laminectomy width was not associated with the incidence of C5 palsy. The risk factors for C5 palsy were the preoperative T2-high lesion in the spinal cord and C4/5 foraminal stenosis on the open side after open-door CLP.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 2","pages":"208-213"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702590","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":"Analysis of Patients Undergoing Anterior Temporal Lobectomy for Drug-Resistant Mesial Temporal Lobe Epilepsy: A Retrospective Study.","authors":"Tural Ahmadov, Tugrul Cem Unal, Ilyas Dolas, Duygu Dolen, Cafer Ikbal Gulsever, Duran Sahin, Nermin Inan, Pulat Akin Sabanci, Yavuz Aras, Nerses Bebek, Altay Sencer, Aydin Aydoseli","doi":"10.5137/1019-5149.JTN.43468-23.3","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.43468-23.3","url":null,"abstract":"<p><strong>Aim: </strong>To analyze the epidemiologic, clinical, neuroradiological, and histopathological data of patients who have undergone anterior temporal lobectomy (ATL) for drug-resistant mesial temporal lobe epilepsy (MTLE).</p><p><strong>Material and methods: </strong>The study included patients who were diagnosed with MTLE refractory to medical treatment, underwent anterior temporal lobectomy at our institution between 2010 and 2020 and had postoperative clinical follow-up data. The epidemiologic, clinical, neuroradiological, and histopathological data of the patients were collected.</p><p><strong>Results: </strong>Fourteen patients were male, and thirty were female. The mean age at seizure onset was 15.3 years. Video electroencephalographic monitoring (VEM), magnetic resonance imaging (MRI), and positron emission tomography (PET) revealed lateralization in 37, 36, and 31 patients, respectively. The cranial MRI and PET were inconclusive in eight patients in whom the diagnosis was verified via invasive monitoring. Thirty-six (81.8%) patients were seizure-free postoperatively. The number and dosage of antiepileptic drugs used were reduced in 35 (79.5%) and 26 (78.8%) patients, respectively. Only six patients developed complications (cerebrospinal fluid fistula, n = 3; central nervous system infection, n = 2; and epidural hematoma, n = 1).</p><p><strong>Conclusion: </strong>Epilepsy is a significant cause of morbidity for patients, and surgery plays a vital role in treating mesial temporal sclerosis, an etiology of epilepsy. Patients can be diagnosed using various tests such as cranial MRI, electroencephalography, VEM, PET, single-photon emission computerized tomography, neuropsychological tests, and invasive monitoring at advanced epilepsy centers. Surgical treatment is highly effective and safe in these patients.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 2","pages":"321-330"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702520","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":"Impact of Obesity on Subarachnoid Hemorrhage-Induced Cerebral Vasospasm: An Experimental Rat Model.","authors":"Baran Can Alpergin, Elif Gokalp, Mustafa Cemil Kilinc, Nermin Aras, Cevriye Cansiz Ersoz, Ihsan Dogan","doi":"10.5137/1019-5149.JTN.47241-24.3","DOIUrl":"10.5137/1019-5149.JTN.47241-24.3","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the effect of obesity on the severity of cerebral vasospasm after subarachnoid hemorrhage.</p><p><strong>Material and methods: </strong>In this study, six experimental groups, each consisting of 10 rats, were defined (60 rats in total). Groups 1 and 2 comprised rats with normal body weight, Groups 3 and 4 comprised obese rats, and Groups 5 and 6 comprised rats that returned to normal body weight after being obese. Rats in Groups 2, 4, and 6, represented the study groups, and experimental SAH was induced in them. Group 1, 3 and 5 was determined as the control group. Basilar artery lumen areas and wall thicknesses were measured and compared in all groups.</p><p><strong>Results: </strong>The luminal area of the basilar artery was significantly reduced in Groups 2, 4, and 6, than in Groups 1, 3, and 5, respectively. This indicated the development of vasospasm. No significant differences were found in the basilar artery luminal areas and wall thicknesses between Groups 1, 3, and 5. However, there were significant differences between Groups 2, 4, and 6. The basilar artery luminal area was significantly smaller in Group 4 than in Groups 2 and 6. There was no significant difference in basilar artery luminal areas between Groups 2 and 6.</p><p><strong>Conclusion: </strong>This experimental study elucidated that the severity of vasospasm subsequent to subarachnoid hemorrhage escalated in the presence of obesity, and conversely, a return to normal body weight mitigated the severity of cerebral vasospasm. Prospective clinical investigations ought to scrutinize the correlation between obesity and vasospasm, emphasizing the necessity for vigilant monitoring of vasospasm post-SAH in obese patients.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"68-75"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804227","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":"Is Unilateral Extended Pterional Craniotomy Adequate Instead of Bicoronal (Bifrontal) Craniotomy in Large or Giant Olfactory Groove Meningiomas?","authors":"Hakan Yilmaz, Emrah Akcay, Alper Tabanli, Onur Bologur, Cafer Ak, Huseyin Berk Benek, Alaettin Yurt","doi":"10.5137/1019-5149.JTN.46246-24.3","DOIUrl":"10.5137/1019-5149.JTN.46246-24.3","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the radiological characteristics, clinical features,and surgical outcomes of bicoronal incision and bifrontal craniotomy for olfactory groove meningiomas (OGMs).</p><p><strong>Material and methods: </strong>This was a retrospective review of 16 patients (nine male and seven female) with large and giant OGMs operated through unilateral extended pterional craniotomy between 2010 and 2022. The radiological characteristics, clinical features,and surgical outcomes were examined.</p><p><strong>Results: </strong>All patients underwent surgical resection via a unilateral extended pterional approach.The mean age of patients was 62.1 years. The most common presenting symptoms were altered consciousness, seizures, headache,and anosmia. Ten (62.5%) and 6 (37.5%) patients had large (4-6 cm) and giant ( > 6 cm) OGMs, respectively. The mean tumor diameter was 6.3 cm (range:4-9). Simpson Grade2 resection was achieved in all 16 patients.</p><p><strong>Conclusion: </strong>Unilateral extended pterional craniotomy offers a safe and effective alternative to the bilateral coronal approach for large and giant OGMs, minimizing risks of frontal lobe retraction, brain edema, and venous infarction. This approach allows for total resection with very low morbidity and mortality rates, making it a viable surgical approach for these complex tumors.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"56-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804230","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":"Retrospective Evaluation of Radiological and Clinical Postoperative Findings of Patients Who Had Endoscopic Lumbar Discectomy.","authors":"Osman Boyali, Gulseli Berivan Sezen, Furkan Diren, Ercan Cetin, Mourat Chasan, Eyup Can Savrunlu, Serdar Kabatas, Erdinc Civelek, Serra Sencer, Altay Sencer","doi":"10.5137/1019-5149.JTN.45972-23.2","DOIUrl":"10.5137/1019-5149.JTN.45972-23.2","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the postoperative magnetic resonance imaging (MRI) findings and clinical outcomes of patients who underwent monoportal endoscopic lumbar discectomy.</p><p><strong>Material and methods: </strong>Preoperative and postoperative 3rd and 6th month MRI features, visual analog scale (VAS), and Oswestry Disability Index (ODI) scores, as well as other clinical features of patients who underwent monoportal endoscopic lumbar discectomy between August 2009 and January 2012 were retrospectively analyzed.</p><p><strong>Results: </strong>A total of 65 patients (37 female, 28 male) were included in the study. VAS and ODI scores showed significant improvement postoperatively (p < 0.001). Intervertebral disc height loss was observed only in two patients. In 31 (48%) of the 64 levels treated, no significant anterior soft tissue mass developed. However, 33 patients (52%) showed anterior epidural edema and tissue formation postoperatively. Contrast enhancement of the nerve root was found in 20 levels (29.4%), nerve root edema in 3 levels (4.41%), and nerve root displacement in 3 levels (4.41%). None of the patients had all 3 aforementioned findings concomitantly. Of the 57 levels evaluated, 36 levels (63%) showed no or minimal changes in the posterior elements, and at the 3rd month, 9 levels (15.8%) demonstrated grade 1+ changes, 9 levels showed grade 2+ changes, and grade 3+ changes were seen in only 3 levels; however, at 6-month follow-up, all vertebral levels showed improvements.</p><p><strong>Conclusion: </strong>Endoscopic discectomy is a safe and effective minimally-invasive method. However, owing to the lack of definitive radiological criteria indicating success or failure, the radiological findings should always be interpreted in conjunction with clinical outcomes.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"101-111"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019412","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}