A Retrospective Review of Radiographic and Clinical Findings from the M6 Cervical Prosthesis

İsmail Oltulu,Özgür Korkmaz,Ender Sarıoğlu,Mehmet Aydoğan 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.6

Study Design: Retrospective clinical study. Purpose: To evaluate clinical results of the M6 cervical prosthesis. Overview of Literature: Cervical disk prostheses have been developed to preserve motion and reduce degeneration in adjacent seg-ments in degenerative disk diseases. Methods: A retrospective evaluation was performed on 43 patients who received the M6 cervical disk prosthesis between 2012 and 2016. Standard and dynamic radiographs, computed tomography, and magnetic resonance imaging were used to evaluate all the patients preoperatively and postoperatively. The Neck Disability Index (NDI) and Visual Analog Scale (VAS) scores were examined in evaluating the clinical and functional results of patients with collapsed disk herniation who had received the M6 cervical prosthesis and to evaluate whether the core structure of the prosthesis protects motion. Results: The mean follow-up period was 34.12±6.70 months. Radiologically, the preoperative cervical segment ROM was measured as a mean of 5.77°±2.19° preoperatively and 8.49°±2.37° at the inal postoperative follow-up examination. In the patients with a preoperative disk height of <4 mm, the segmental ROM increased from 4.53°±2.79° preoperatively to 7.2°±3.18° postoperatively. In the patients with a preoperative disk height of >4 mm, the cervical segment ROM increased from 6.4°±1.45° preoperatively to 8.6°±2.02° at the inal postoperative follow-up examination. The NDI scores reduced from 53.86±9.77 preoperatively to 22.69±7.26 postop-eratively and the VAS scores reduced from 8.74±0.58 to 1.88±1.14. During follow-up in any patient, no collapse of the levels at which surgery was performed was observed. No heterotopic ossiication or implant failure was recorded in any patient during the follow-up period. Conclusions: The M6 new-generation cervical disk prosthesis had few complications. No heterotopic ossiication was observed in any patient, and lexion-extension ROM was maintained in all the patients, indicating the M6 prosthesis as a promising alternative.

Intraoperative Halo-Femoral Traction in Surgical Treatment of Adolescent Idiopathic Scoliosis Curves between 70° and 90°: Is It Effective?

Mehmet Nuri Erdem,Ismail Oltulu,Sinan Karaca,Seçkin Sari,Mehmet Aydogan 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.4

Study Design: A retrospective clinical study. Purpose: To analyze the surgical outcomes of intraoperative halo-femoral traction (HFT) in patients with adolescent idiopathic scoliosis (AIS) with Cobb angles between 70° and 90° and flexibility <35%. Overview of Literature: Numerous methods have been described to achieve adequate correction and successful results in the surgical treatment of AIS patients with a Cobb angle >70°. However, few studies have evaluated the results of HFT in AIS patients with Cobb angles between 70° and 90° and flexibility <35%. Methods: The study comprised 24 AIS patients (18 females, six males; mean age, 17.4 years; mean preoperative Cobb angle, 80.1°; range, 70°–90°) who underwent surgery using intraoperative HFT. Neurological status was constantly assessed during the surgery using intraoperative neurophysiological monitoring. Results: The mean follow-up period was 33.5 months. Radiographic outcomes demonstrated 85.7% correction of the major Cobb angle. Coronal and sagittal balance was achieved in all the patients, and shoulder levels were equalized. The traction was discontinued when a decrease in spinal cord potentials was observed during the surgery. Conclusions: Intraoperative HFT is an effective and reliable method for the management of scoliosis curves between 70° and 90°. The most significant advantages of the method are avoidance of the morbidities related to anterior surgery, osteotomy, or vertebral column resection; its contribution in helping achieve adequate reduction and optimum balance by the gradually increased corrective force, lack of any need for extreme correction force during instrumentation; and the high correction rates achieved.

GSTT1 is Deregulated in Left Colon Tumors

Coskunpinar, Ender,Canbay, Emel,Oltulu, Yasemin Musteri,Tiryakioglu, Necip Ozan,Bugra, Dursun Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.5

Our aim was to determine GSTT1 expression levels in left colon tumors and paired normal tissue in order to identify specific alterations in GSTT1 mRNA levels. Alterations in GSTT1 expression in twenty-four left-sided colon tumors and paired cancer free tissue were determined by qRT-PCR. Significant fold changes were determined with t-test. When compared with cancer free tissue, left colon cancers showed a significant decrease in GSTT1 expression. However, GSTT1 mRNA levels among different grades increased gradually in correlation with tumor grade. Our results suggest that downregulation of GSTT1 in left-sided colon cancers is an early event and is reversed with cancer progression, probably due to cellular defense mechanisms as a response to changes in the microenvironment.

Unilateral Posterior Surgery for Severe Osteoporotic Vertebrae Fractures’ Sequelae in Geriatric Population: Minimum 5-Year Results of 109 Patients

Tuna Pehlivanoglu,Yigit Erdag,Ismail Oltulu,Umut Dogu Akturk,Emre Korkmaz,Kerem Yildirim,Ender Sarioglu,Kerem Gun,Ender Ofluoglu,Mehmet Aydogan 대한척추신경외과학회 2021 Neurospine Vol.18 No.2

Objective: This study aimed to evaluate the efficacy and safety of modified posterior vertebral column resection (PVCR) combined with anterior column restoration in elderly patients presenting with thoracic or thoracolumbar osteoporotic fractures with spinal cord compression and severe pain. Methods: One hundred nine patients with one level thoracolumbar osteoporotic fracture and at least 5 years of follow-up were included. They underwent posterior instrumentation performed with polymethymetachrylate augmented pedicle screws. A modified PVCR (unilateral costotransversectomy+hemilaminectomy) combined with the insertion of an expandable titanium cage for anterior column restoration was undertaken. Patients were evaluated clinically and radiographically. Results: Patients had a mean age of 74.1 and a follow-up duration of 92.3 months. Mean duration of operations, hospital stays, and mean loss of blood were 172.3 minutes, 4.3 days, and 205.4 mL. All of the patients were mobilized immediately after surgery. The mean preoperative local kyphosis angle improved from 39.3° to 4.7° at the last follow-up (p=0.003). Patients preoperative mean visual analogue score, Japanese Orthopaedic Association, and Oswestry Disability Index scores improved from 7.7/8.6/76.3 to 1.6/26.1/17.4 (p<0.001 for all), respectively. The average 36-item Short-Form survey physical component summary/mental component summary scores at the last follow-up were 55.1/56.8. A dural tear was detected intraoperatively in 1 patient and repaired immediately. Conclusion: Subtotal PVCR combined with the insertion of an expandable titanium cage was detected as a safe and effective method for osteoporotic vertebrae fractures’ sequelae in the older population involving spinal cord compression by enabling the decompression of the spinal canal and reconstruction of the resected segment, resulting in significant improvement in clinical and radiographic outcomes.

Compartment Syndrome Following Arthroscopic Removal of a Bullet in the Knee Joint after a Low-Velocity Gunshot Injury

Mert Keskinbora,Sercan Yalçin,İsmail Oltulu,Mehmet Emin Erdil,Tuğrul Örmeci 대한정형외과학회 2016 Clinics in Orthopedic Surgery Vol.8 No.1

Gunshot injuries are getting more frequently reported while the civilian (nongovernmental) armament increases in the world. A 42-year-old male patient presented to emergency room of Istanbul Medipol University Hospital due to a low-velocity gunshot injury. We detected one entry point on the posterior aspect of the thigh, just superior to the popliteal groove. No exit wound was detected on his physical examination. There was swelling around the knee and range of motion was limited due to pain and swelling. Neurological and vascular examinations were intact. Following the initial assessment, the vascular examination was confirmed by doppler ultrasonography of the related extremity. There were no signs of compartment syndrome in the preoperative physical examination. A bullet was detected in the knee joint on the initial X-rays. Immediately after releasing the tourniquet, swelling of the anterolateral compartment of the leg and pulse deficiency was detected on foot in the dorsalis pedis artery. Although the arthroscopic removal of intra-articular bullets following gunshot injuries seems to have low morbidity rates, it should always be considered that the articular capsule may have been ruptured and the fluids used during the operation may leak into surrounding tissues and result in compartment syndrome.