AIm: Cervical spine is the most kinetic segment of the whole vertebrae. The radiologic imaging methods concern with the morphologic changes but give no functional data. At flexion, spinal cord strains, anterior osteophytic compression increases. At extension, spinal canal gets narrower, cord shortens and gets thicker, compression of posterior ligament gets abberant and cord compression increases. mATErIAl and mEThOds: 258 cervical spondylotic myelopathy (CSM) cases were scanned by conventional magnetic resonance imaging (MRI) and additionally dynamic MRI. Contributions of dynamic cervical MRI to the surgical plans and results were evaluated. rEsulTs:We had sagittal and axial T2W MR scans at flexion and extension, in addition to the neutral cervical MR imaging. We found that the AP diameter of spinal canal is increased 14.9 % in flexion and decreased 13.4 % in extension relative to the neutral MR imaging. CONClusION:The changes of the cord compression and the transvers area of cord which is the most important prognostic indicator in spinal diseases and also the area of spinal cord and subarachnoid space can be detected via dynamic axial sections of MRI. Dynamic MR images may be helpfull in the decision making for the surgical treatment of CSM.KEywOrds: Cervical, Cervical spondylotic myelopthy, Dynamic, MRI ÖZ AmAÇ: Servikal vertebra omurganın en hareketli bölümüdür. Radyolojik incelemeler omurga yapısı hakkında bilgi verse de fonksiyonel olarak herhangi bir veri sağlamamaktadır. Fleksiyon duruşunda omurilik gerilir ve ön tarafta yer alan osteofitik değişikliklerin basısı artmaktadır. Ekstansiyon duruşunda ise spinal kanal daralmakta, omurilik kısalmakta ve genişlemekte ve arka tarafta yer alan posterior ligamentlerin basısı artmaktadır. yÖNTEm ve GErEÇlEr: 258 servikal spondilopatik miyelopati hastası klasik MR görüntülerine ek olarak dinamik MR görüntüleri ile incelendi. Dinamik servikal MR görüntülemeleri ile cerrahi planlama ve sonuçları incelendi. BulGulAr:Hastaların fleksiyon ve ekstansiyon duruşunda T2 ağırlıklı sagital ve aksiyel kesitlerine ek olarak nötr duruşta servikal MR görüntüleri elde edildi. Hastaların ön-arka spinal kanal çapı nötral duruşla karşılaştırıldığında fleksiyon duruşunda %14,9 artarken, ekstansiyon duruşunda %13.4 azalmaktadır. sONuÇ: Spinal hastalıklarda spinal kord basısındaki değişiklikler ve spinal kanalın transvers alanındaki değişiklikler prognostik önem taşımaktadır. Spinal kord ve subaraknoid alan ölçümleri dinamik MRG ile elde edilen aksiyel kesitlerden elde edilebilir. Dinamik manyetik rezonans görüntülemeleri servikal spondilopatik miyelopatinin cerrahi kararını vermede yardımcı olmaktadır.
Aim: Many antioxidant compounds have been tried to prevent traumatic brain injury (TBI). In this study, we aimed to demonstrate the therapeutic effect of Resveratrol in the hippocampus in TBI by histopathologic and immunologic evaluation. Study Design: Twenty-four male Sprague-Dawley rats were divided into Control, TBI, TBI+Resveratrol (20 mg/kg/day, oral) groups. Rats were subjected to traumatic brain injury by dropping the weight from a height with a 50 g/1m weight-height impact device. All rats were decapitated 14 days after trauma induction and the protective effects of Resveratrol were evaluated by histopathological and immunohistochemical analyses. Result: In the TBI group, degeneration of cells, dilatation of vessels and apoptosis due to traumatic inflammation were observed in the alveus and pyramidal layer. In the plexiform layer, synaptic degeneration was present in nerve extensions. In TBI+Resveratrol group, vascular dilatation was decreased and axonal extensions were normal, hyperplasia was observed in pyramidal neurons. S100 expression was positive in pyramidal neurons, glial cells and vascular endothelium. In the Resveratrol treated group, negative expression was observed in membranes, pyramidal neurons and positive s100 expression was observed in plexiform layer and axons. Conclusion: We suggest that after TBI, Resveratrol treatment alleviates cerebral tissue pathology and can be demonstrated by s100 expression in neuronal regeneration. Keywords: Traumatic brain injury, hippocampus, s100, Resveratrol, immunohistochemistry
Background. The inflammatory index can be useful for neurosurgeons to understand and grade pain in degenerated intervertebral disc (DIVD).Objectives. The study focused on the value of the platelet-to-lymphocyte ratio (PLR), neutrophil-tolymphocyte ratio (NLR) and the inflammatory multiple indices (MIs), and aimed to compare its efficiency with the preoperative and postoperative pain scale and scoring algorithms. Materials and methods.A total of 88 DIVD patients were included in this retrospective clinical cohort study. Visual Analogue Scale Back (VASB) and Visual Analogue Scale Leg (VASL), Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and walking distance (WD) were used to assess pain. The multiple index (MI) was calculated as MI-1 = PLR × C-reactive protein (CRP) and MI-2 = NLR × CRP. Results.Comparing the MI with ODI, no correlation was found in preoperative values, while a positive correlation (MI-1: r = 0.398, p < 0.001; MI-2: r = 0.285; p = 0.007) was found between the postoperative measurements. A significant correlation was found for VASB and both MI-1
Introduction: Posterior spinal instrumentation is a fairly common surgical procedure for the treatment of degenerative spine pathologies. The development of adjacent segment degeneration (ASD) after spinal instrumentation is an important problem. The aim of this study is to evaluate the risk factors for the development of ASD. Materials and Methods: In this study, 126 patients who underwent posterior segmental instrumentation and who had undergone surgery for more than 4 years were reviewed retrospectively. These patients were divided into two groups as ASD and non-ASD. By comparing the patient characteristics, preoperative and postoperative radiological parameters and surgical differences of the two groups, predictive factors for the development of ASD were tried to be revealed. Results: Fifteen of the patients (11.9%) included in the study had ASD. There was no significant difference between the two groups in terms of gender, diabetes mellitus, smoking and osteoporosis (p>0.05). According to logistic regression analysis, preoperative high body mass index, presence of facet degeneration in the preoperative adjacent segment, decrease in postoperative lumbar lordosis, and posterior instrumentation of more than 4 levels are independent risk factors for the development of ASD. Conclusion: Knowing the above-mentioned risk factors before spinal instrumentation surgery allows taking precautions to obtain more appropriate surgical results. We think that taking the necessary precautions in terms of risk factors that can be modified by the patients and the surgeons who will perform the procedure can reduce long-term complications.
Introduction: Inflammatory Prognostic Index (IPI), calculated via Albumin, CRP, and Neutrophil-Lymphocyte Ratio (NLR), is used in inflammation-related diseases. The study focused on the efficacy and predictive effect of the IPI in terms of Visual Analog Scales (VAS) for interpretation of back and leg pain. Materials and Methods: This multicenter retrospective clinical study was performed by the hospital records of the DIVD patients treated between January 2020 and February 2022. IPI value was calculated by the formula of “CRPxNLR/Albumin”. Results: There was a significant difference between VAS-B (2.38±1.74; p=0.0001) and VAS-L (7.09±1.44; p=0.00017) in the comparison of paired VAS values before and after the surgery. A similar change occurred within walking distance after surgery. According to the correlation analysis of the IPI index with DIVD pain scoring, VAS-B(r=0,391; p=0,00017) and delta VAS-B (r=0,422; p=0,00004) showed a positive correlation with the IPI. In the ROC analysis for the diagnostic value of the IPI, the cut-off value of VAS-L above 0.184 showed a diagnostic value as 78.9% sensitivity and 64.3% specificity [UAC:0.702; p:0.003; CI%95: 0.581-0.815). Conclusion: We showed a strong relationship between IPI and pain scoring of DIVD. The diagnostic value of IPI with VAS-L was very important and can be used by physicians for pain follow-up of DIVD.
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