Browsing by Author "Dalbayrak, Sedat"

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Citation Count: 0
Acute spinal epidural hematoma: A case report and review of the literature
(Turkish Assoc Trauma Emergency Surgery, 2020) Akar, Ezgi; Ogrenci, Ahmet; Koban, Orkun; Yilmaz, Mesut; Dalbayrak, Sedat
Spinal epidural hematoma (SEH) is a rare but a significant cause of spinal cord compression and neurologic deficits. Its etiology is usually unknown and requires emergency intervention. The present study aims to review the clinical significance, treatment strategies and clinical outcomes of traumatic SEH with a rare case presentation. Our patient was a 42-year-old female who presented with back pain and loss of sensation and strength in the legs. The patient did not have any disease and did not use anticoagulant drugs. The patient developed numbness in her legs half an hour after having a traditional back walking massage due to occasional back pain. She was paraplegic and anesthetic when seen in our clinic. Thoracic computed tomography (CT) and magnetic resonance imaging (MRI) revealed posterior epidural hemorrhage at Th3-Th4 levels. In the 12th hour, the hematoma was evacuated by an emergency decompressive hemilaminectomy. At the postoperative 24th hour, the patient had symptomatic improvement, and in the sixth month, the patient was mobilized with support. SEH is a rare condition that should be considered in patients with sudden onset of back pain and extremity weakness. Although the gold standard diagnostic tool is MRI, CT is often sufficient to avoid delayed surgery. Immediate surgical decompression (laminectomy/hemilaminectomy) should be performed in cases diagnosed with SEH with neurological deficits.
Citation Count: 1
Any Instrument in a Surgeon's Hand can be Fatal: Unusual Iliac Artery Injury in Lumbar Spinal Deformity Surgery
(Elsevier Science inc, 2020) Koban, Orkun; Akar, Ezgi; Ogrenci, Ahmet; Yilmaz, Mesut; Dalbayrak, Sedat
BACKGROUND: Vascular complications, which we rarely encounter during lumbosacral stabilization surgeries, can be life-threatening if they are not treated quickly. These arterial injuries occur during screw insertion. Our presentation with the common iliac artery injury during the decortication process in transverse processes with the "pedicle awl" will be the first case in the literature to our knowledge. CASE DESCRIPTION: Lumbosacral decompression and stabilization surgery was performed in a 57-year-old patient with L1-S1 spinal stenosis and scoliosis. After the stabilization process was completed, while decorticating the transverse processes with the pedicle awl, the tool fell to the paravertebral region, and then active arterial hemorrhage was observed at the surgical site. Hemostasis was achieved in the surgical field, but a rapid progressive drop was observed in the patient's blood pressure. The surgery was quickly terminated, and the patient was turned to the supine position. Vascular surgeons opened the abdomen with a midline laparotomy, and approximately 2600 mL hematoma was evacuated from the retroperitoneum. The 5-mm defect in the left common iliac artery was repaired by primary suturing. The patient had no problem in postoperative follow-up and was discharged on the 10th postoperative day. CONCLUSIONS: In these complications that we rarely encounter in lumbosacral stabilization surgeries, perioperative findings should be well evaluated, and rapid intervention should be made in cases in which vascular injury is considered. One must remember that every tool used during surgery can be dangerous even in an experienced hand.
Citation Count: 0
Clinical and radiological outcomes after correction of degenerative lumbar scoliosis with dynamic stabilization (with the help of a rigid rod); and describing an alternative technique
(Elsevier Sci Ltd, 2020) Dalbayrak, Sedat; Ogrenci, Ahmet; Akar, Ezgi; Koban, Orkun; Yilmaz, Atilla; Yilmaz, Mesut
Sharing clinical and radiological results in patients with degenerative lumbar scoliosis (DLS) treated surgically with dynamic system and describing an alternative technique for scoliosis correction. Between 2013 and 2018, 48 patients with flexible degenerative lumbar scoliosis (DLS) were operated with dynamic stabilization with Polyetheretherketone Rod (PEEK rod) after rigid rod application. Preoperative and postoperative scoliosis angles (standing and supinel were statistically compared. Preoperative and postoperative low back pain (LBP) Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were compared. In addition, preoperative C7 Sagittal Vertical Axis (SVA) values and lumbar lordosis angles were compared with postoperative values. The mean follow-up period of the patients was 48.3 months (range 30-76), the mean age was 67.08 (range 49-84). While the average Cobb angle of all patients was 9.65 in preoperative supine position, the average Cobb angle with standing position was 19.73. The mean standing Cobb angle of the patients after surgery was 3.52. The mean Cobb angle in the supine position after surgery was 3.02. The difference between the preoperative and postoperative patients' Cobb angles in standing and supine position were statistically significant (p:0,000, p:0,000, respectively). The differences of VAS and ODI scores between preoperative and postoperative period were statistically significantly (p:0,000, p:0,000; respectively). Especially in patients with flexible LDS, the technique we have defined and dynamic stabilization with PEEK rod provides significant correction. There was no loss of correction in our patients during postoperative follow-up period. PEEK rod is insufficient for lordosis increase and correction of SVA values. (C) 2020 Elsevier Ltd. All rights reserved.
Citation Count: 0
Comparing Ipsilateral and Contralateral Laminotomy with Bilateral Decompression in Cases with Far Lateral Disk Herniation and Lumbar Spinal Stenosis
(Georg Thieme verlag Kg, 2021) Akar, Ezgi; Ogrenci, Ahmet; Koban, Orkun; Yilmaz, Mesut; Dalbayrak, Sedat
Introduction The aim of this study was to compare clinical results of bilateral decompression and laminotomy and contralateral laminotomy following discectomy from the same side in patients who have far lateral disk herniation and lumbar spinal stenosis at the same level. Materials and Methods Twenty-four patients with far lateral disk herniation have been divided into two groups: group 1 (n = 14), those who have been through bilateral canal decompression with far lateral discectomy and ipsilateral approach, and group 2 (n = 10), those who have been through far lateral discectomy and bilateral decompression with unilateral approach from contralateral side. Early postoperative, 1st month, and 12th month back and leg pain Visual Analogue Scale (VAS) scores of the patients have been retrospectively evaluated. Results There is no significant difference between 1st month back and leg pain VAS scores of the groups. But 12th month back and leg pain VAS scores of group 1 are significantly higher than 1st month VAS scores. Also, 12th month back and leg pain VAS scores of group 1 are significantly higher than group 1. In the scanning carried out when the complaints of eight patients in group 1 continued, pars interarticularis fracture has been observed on the side where the surgery has been performed (57.1%). Six of these eight patients have been through stabilization surgery (42.8%). Conclusion Long-term postoperative results are better in cases who have been performed bilateral decompression with unilateral approach from contralateral side with median incision following paramedian incision discectomy in patients with far lateral disk herniation and spinal stenosis.
Citation Count: 0
In response to: "Cement or Calcitonin for Coccyx Fractures"
(Galenos Publ House, 2021) Akar, Ezgi; Koban, Orkun; Ogrenci, Ahmet; Yilmaz, Mesut; Dalbayrak, Sedat
[No Abstract Available]
Citation Count: 0
A Novel Placement Technique of S2 Screw (from S2 to Promontorium) and Double Screwing from S2
(Georg Thieme verlag Kg, 2021) Dalbayrak, Sedat; ogrenci, Ahmet; Akar, Ezgi; Koban, Orkun; Yilmaz, Mesut
Since pseudoarthrosis or screw loosening is frequently seen in lumbosacral stabilizations ending in S1, S2 screws are used more frequently to support S1 screws. This study aims to describe a new screw placement technique and location from S2. Revision surgery was applied to the patient who had previously undergone surgery with the rigid instrumentation system and encountered pseudoarthrosis during the follow-up period. Instrumentation was performed from S2 to the promontorium. The patient's chronic low back pain arising due to pseudoarthrosis was reduced and a strong lumbosacral dynamic instrumentation was performed to the patient. Dual screw placement from S2 and/or screw placement in the S2-promontorium direction is a new alternative to provide a powerful instrumentation.
Citation Count: 5
Polymethylmetacrylate Cement Augmentation of the Coccyx (Coccygeoplasty) for Fracture: A Case Report
(Galenos Publ House, 2020) Akar, Ezgi; Koban, Orkun; Ogrenci, Ahmet; Yilmaz, Mesut; Dalbayrak, Sedat
Background: Coccydynia is a painful condition of the sacrococcygeal region, with symptoms associated with sitting and rising from a seated position. It is frequently related to trauma and idiopathic causes, and the pain is mostly chronic. Pere utaneous vertebroplasty and sacroplasty are the methods that are widely used for treating compression fractures and sacral insufficiency fractures, respectively. However, the success of polymethylmethacrylate injection in the treatment of osteoporotic coccyx fractures and coccydynia is still unknown. Case Report: A 68-year-old man was admitted to our clinic with complaints of pain in the sacrococcygeal and perianal regions. In the imaging studies, a fracture line in the fifth sacral and first coccygeal segments was observed as evidenced by a bony edema. Since the patient's pain did not improve with conservative methods, we treated him with coccygeoplasty. No complication was encountered. The day after the operation, he was discharged from the hospital with complete pain relief. The patient confirmed having no pain on the third postoperative month and so did not need any analgesics. Conclusion: Coccyceoplasty may be a good treatment option for retractable pain in patients with acute or subacute osteoporotic coccygeal fractures and coccydinia with edema.
Citation Count: 0
Radiological and clinical comparisons of the patients with rheumatoid arthritis operated with rigid and dynamic instrumentation systems due to lumbar degenerative spinal diseases
(Elsevier, 2021) Koban, Orkun; Ogrenci, Ahmet; Akar, Ezgi Aycicek; Uyanik, Ahmet Sadik; Yilmaz, Mesut; Dalbayrak, Sedat
Background: It is extremely difficult to treat spine disorders with stabilization in patients with rheumatoid arthritis. Because revision rates are significantly higher in rigid stabilization. To date, there is no data about patients with rheumatoid arthritis treated with dynamic stabilization. Our aim was to compare the radiological and clinical results of patients with rheumatoid arthritis who underwent lumbar rigid stabilization or dynamic stabilization with Polyetheretherketone rod (PEEK). Methods: Patients with degenerative lumbar spine disease with rheumatoid arthritis who underwent dynamic stabilization between 2013 and 2015 and rigid stabilization between 2010 and 2012 were evaluated radiologically for adjacent segment disease, proximal junctional kyphosis, system problem (nonunion, screw loosening, instrumentation failure, pull out). It was also compared according to both the revision rates and the Visual Analog Scale and Oswestry Disability Index scores at the 12th month and 24th month. Results: The difference of decrease in Visual Analog Scale and Oswestry Disability Index scores from preoperative to 12th month between patients who underwent dynamic stabilization and rigid stabilization was statistically insignificant. However, there was a significant difference of increase in Visual Analog Scale and Oswestry Disability Index scores between the 12th month and 24th month of patients who underwent rigid stabilization, compared with patients with dynamic stabilization. In patients with dynamic stabilization, the problems of instrumentation were seen less frequently. Revision rates were high in patients with rigid stabilization when compared the patients with dynamic stabilization. Conclusion: Radiological and clinical outcomes in patients with rheumatoid arthritis operated with dynamic stabilization are more significant when compared to rigid stabilization. These patients have lower pain and disability scores in their follow up periods. Revision rates are lower in patients with dynamic stabilization. (C) 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
Citation Count: 3
Spinal anesthesia in surgical treatment of lumbar spine tumors
(Elsevier, 2020) Ogrenci, Ahmet; Akar, Ezgi; Koban, Orkun; Isik, Semra; Sener, Mesut; Yilmaz, Mesut; Dalbayrak, Sedat
Objective: This study aims to show the feasibility of spinal anesthesia in lumbar spinal tumor surgery; share our data and experience. Patients and methods: : A retrospective review of 14 patients with high risk for general anesthesia due to severe comorbidities was carried out. Patients who underwent surgeries under spinal anesthesia for lumbar vertebral column or spinal cord tumors at a single center between 2007-2019 were evaluated. The final pathological diagnosis, operation time, and surgical procedures were analyzed. Also, preoperative and postoperative ad-vantages and disadvantages were determined. A comparison was performed with other 184 patients who were operated for spinal tumors in the same period under general anesthesia. Results: Maximum operation time was found 220 min, and the average operation time was 166 min. The most primary diagnosis was vertebral column metastasis. The mean age was 65.5 years. None of the patients required general anesthesia during surgery; however, two patients needed additional spinal anesthesia preoperatively, which was performed by the surgeon. Lumbar decompression and fusion were the most performed procedures. Conclusion: Spinal anesthesia is a feasible and useful method of anesthesia in lumbar spinal tumor surgery for especially elderly patients with American Society of Anesthesiologists (ASA) 3 or 4 score and high risk of general anesthesia.
Citation Count: 0
Three region spinal decompression in the same session: a case report
(Taylor & Francis Ltd, 2023) Akar, Ezgi; Ogrenci, Ahmet; Koban, Orkun; Yilmaz, Mesut; Dalbayrak, Sedat
Background and importance Multiregional spinal stenosis [tandem spinal stenosis (TSS)] is not rare but operating on multiple regions at the same sitting is. Decompression of cervical and lumbar spine in the same session has a frequency of 5-25% all TSS cases, the most frequent one is TSS. Decompression in three different regions is so rare that there is only one case in the literature. We report the second. Clinical presentation A 72-year-old man with pain in legs and arms, neurogenic claudication, progressive loss of balance, radiculopathy and myelopathy in lower and upper extremities whose cervical-thoracic and lumbar spinal stenosis were treated with decompressive surgery in the same session. Total time of surgery for three regions was 330 min. No complications were observed. The patient was mobilized on day 1 postoperative and was discharged from the hospital on day 3. By month 3, motor function had improved almost completely, and pyramidal findings have decreased. Conclusion Multiregional spinal stenosis of three spinal regions at the same time is a rare case and these cases, surgery of three regions can be carried out in the same session respectively.
Citation Count: 0
Torakolomber Bölgenin Posttravmatik Deformitelerinde Tedavi: Tanım – Cerrahi Tedavi Endikasyonları – Yöntemler ve Seçimi
(2020) Koban, Orkun; Dalbayrak, Sedat
Posttravmatik deformite, omurga kırıkları sonrasında konservatif ve cerrahi tedaviler uygulansa bile gelişebilmektedir. Bunungelişmemesi için en önemli faktör omurga kırığı hastalarının gerekli radyolojik ölçümlerle yakından takip edilmesidir. Patolojikboyutlara ulaşmadan, birkaç derecelik kayıp hastaların çoğunda yaşanabilecek bir sonuçtur. Progresif semptomları (ağrı, nörolojik)olan ve omurga dengesini bozacak deformite gelişen hastalarda erken müdahale ile durum kontrol altına alınmalıdır. Eğer kırığayönelik primer cerrahi tedavi uygulanacaksa enstrümantasyon kurgusu anterior kolona binen yükleri ve posterior kolon gerginliğinikarşılayabilecek güçte tasarlanmalıdır. Gerek omurga kırıklarının gerekse posttravmatik deformitelerin cerrahi yönetiminde cerrahınbilgi ve tecrübesi tek başına yeterli olmayabilir. Olası komplikasyonların oluşmasını önlemeye yardım edecek ve komplikasyongelişmesi durumunda etkin müdahale yapabilecek cerrahi dışı diğer bölümlerinde dahil olduğu bir ekip işi olduğu unutulmamalıdır
Citation Count: 0
Vertebroplasty with Decompression for Epidural Extending Vertebral Hemangiomas: An Alternative Technique
(Turkish Neurosurgical Soc, 2020) Koban, Orkun; Ogrenc, Ahmet; Yilmaz, Mesut; Dalbayrak, Sedat
AIM: To document the effectiveness of an alternative surgical technique with concurrent vertebroplasty and decompression without instrumentation for patients with vertebral hemangioma presenting with neural compression symptoms. MATERIAL and METHODS: This study is a technical note and a retrospective clinical evaluation. We analyzed the data of 8 patients operated with our alternative surgical technique for vertebral hemangiomas with epidural extension and neural compression, between 2013 and 2018. The preoperative, postoperative 1st month and postoperative 12th-month Visual Analogue Scale (VAS) scores were assessed and compared. RESULTS: Five of the patients had lumbar and 3 had thoracic hemangiomas. The difference between preoperative and 1st and 12th-month Visual Analogue Scale scores were statistically significant. None of the patients received additional intervention, stabilization, or needed a blood transfusion. CONCLUSION: This technique is a safe and minimally invasive approach for vertebral hemangiomas with epidural extension allowing decompression of the spinal cord without massive hemorrhage.