Turkish neurosurgery最新文献

{"title":"Analysis of Preoperative Imaging Factors and Development of a Nomogram Model for Predicting Recurrence in Patients with Septated Chronic Subdural Hematoma.","authors":"Xi Cao, Kunliang Huo, Liang Chen, Jiayu Li, Ziyin Yang, Jun Huang, Anliang Gao","doi":"10.5137/1019-5149.JTN.46686-24.1","DOIUrl":"10.5137/1019-5149.JTN.46686-24.1","url":null,"abstract":"<p><strong>Aim: </strong>To develop a nomogram model that provides a clinical prediction method for preventing septated chronic subdural hematoma (sCSDH) recurrence after surgery and serves as a reference for selecting surgical approaches.</p><p><strong>Material and methods: </strong>This study involved 237 patients diagnosed with sCSDH. Based on the recurrence status of the affected side during follow-up, patients were divided into a recurrence group (43 cases) and a non-recurrence group (194 cases). The imaging-related factors influencing the recurrence of sCSDH after surgery were initially screened using univariate analysis, followed by multivariate logistic regression analysis to identify independent risk factors. A nomogram model was developed using R software, and internal validation was conducted using the bootstrap method.</p><p><strong>Results: </strong>The univariate analysis revealed that cerebral atrophy, bilateral hematomas, preoperative midline shift distance, sCSDH typing, and neovascularization were the significant factors in the postoperative recurrence of sCSDH. However, the multivariate logistic regression analysis identified encephalatrophy, bilateral hematomas, and neovascularization as independent risk factors for sCSDH recurrence. Furthermore, the nomogram model analysis demonstrated good discrimination with an AUC of 0.764 (95% CI: 0.6958-0.8322), while the P-value of the Hosmer-Lemeshow test was 0.4382, indicating good consistency.</p><p><strong>Conclusion: </strong>Encephalatrophy, bilateral hematomas, and neovascularization are independent imaging risk factors associated with sCSDH recurrence. The developed nomogram model will enable clinicians to assess and identify patients at a higher risk of sCSDH recurrence, enabling them to formulate appropriate diagnostic and treatment strategies.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 2","pages":"251-256"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702522","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":"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":"Intracranial Sewing Needles as Foreign Bodies: A Report of Two Cases.","authors":"Ozan Hasimoglu, Buruc Erkan, Bekir Tugcu","doi":"10.5137/1019-5149.JTN.47425-24.2","DOIUrl":"10.5137/1019-5149.JTN.47425-24.2","url":null,"abstract":"<p><p>Penetrating brain injuries are usually the result of high-velocity accidents. However, intracranial foreign bodies can also rarely occur as a result of child abuse. Inserting a sewing needle into the brain through the sutures before the closure of fontanelles represents a particularly intriguing and relatively unknown form of attempted infanticide. In this study, we analyzed two adults who presented with an intracranial foreign body. Case 1: A 36-year-old woman presented with complaints of headache. Radiographic evaluation revealed a sewing needle lodged in her brain. Case 2: A 62-year-old man was admitted with seizures. Radiographic examination revealed three sewing needles in his brain. Both patients were managed conservatively due to the non-threatening nature of their symptoms. Several victims of needle insertion incidents go unreported. Survivors of such incidents may present with late complications. The needle is often incidentally detected during adulthood. A limited number of publications indicate that authors tend to refrain from treating asymptomatic patients. Furthermore, the related ethical concerns pose significant challenges for the physicians.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"809-815"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994933","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":"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":"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":"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":"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":"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":"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":"Step-by-Step Dissection of the Pterygopalatine Fossa, Infratemporal Fossa, and Parapharyngeal Space via the Middle Cranial Fossa Approach with Preservation of the Temporomandibular Joint.","authors":"Yandong Su, Zhao Wang, Hongxiang Wang, Juxiang Chen","doi":"10.5137/1019-5149.JTN.46257-24.3","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.46257-24.3","url":null,"abstract":"<p><strong>Aim: </strong>To illustrate the middle cranial fossa (MCF) approach to the pterygopalatine fossa (PPF), infratemporal fossa (ITF), and parapharyngeal space (PPS) with temporomandibular joint (TMJ) preservation through step-by-step cadaver dissection and discuss certain critical considerations that are inadequately addressed in the literature.</p><p><strong>Material and methods: </strong>Six sides of three formalin-fixed, latex-injected specimens were dissected under an operating microscope to illustrate this unique approach. All steps were documented.</p><p><strong>Results: </strong>The MCF approach with TMJ preservation provides excellent access to the PPF and ITF, and limited exposure of the PPS. Key steps include positioning and craniotomy, lateral loop drilling, MCF removal, PPF dissection, ITF dissection, maxillary artery dissection, and PPS dissection.</p><p><strong>Conclusion: </strong>The MCF is a promising corridor for accessing these complex exocranial skull base areas. Although live surgery may be quite different from cadaver dissection, every surgeon must master the relevant anatomy before entering the operation theatre.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 3","pages":"377-387"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153169","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":"Comparison of Mechanical Stress on Implants in Anterior Single and Double Screw Fixation of Odontoid Fractures in a Finite Element Model.","authors":"Kemal Paksoy, Idris Avci, Ozan Baskurt","doi":"10.5137/1019-5149.JTN.47277-24.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.47277-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effect of single and double anterior odontoid screw fixation on the ROM of the craniocervical area and the stress distribution on the implants in a Finite Element Analysis which may give us ideas about the possible results for IF and malunion.</p><p><strong>Material and methods: </strong>A FE model of the craniocervical area was constructed and a type II fracture model was created. In model A, a single screw and in model B two screws were used to fixate the model. The ROM and von Misses stress distribution on implants was evaluated.</p><p><strong>Results: </strong>The ROM values of the models with fixation closely resembled those of the intact model, showing less than a 10% difference in ROM. Under loading conditions in flexion, extension, rotation and lateral bending directions for each model, both structures exhibited similar stress distributions. In both models, the stress was distributed throughout the whole shaft, whereas during lateral bending and rotation, the stress was localized more on the distal part. But the maximum stress on implants were higher in the single screw model.</p><p><strong>Conclusion: </strong>We believe that double odontoid screws decrease the stress on implants, thus decreasing the risk of IF without significantly affecting ROM.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 3","pages":"395-402"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153044","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}