IntroductionThe purpose of this study was to determine whether ligamentum flavum hypertrophy among disc herniated patients causes contralateral pain symptoms. For this reason we measured the thickness of the ligament in disc herniated patients with ipsilateral or contralateral symptoms.Material and methodsTwo hundred disc herniated patients with ipsilateral symptoms as group I were compared with five disc herniated patients with only contralateral symptoms as group II. Ligamenta flava thicknesses and spinal canal diameters of both groups were measured on magnetic resonance imaging (MRI) with a micro-caliper.ResultsBoth groups underwent surgery only on the disc herniated side. The total thicknesses of the ligamenta flava in group II was thicker than in group I. There was no spinal stenosis in either group and no significance difference between the groups. Statistically significant differences were found for both ipsilateral and contralateral thickness of the ligament flava in both groups. We also compared thickness of the ligamenta flava for each level of disc herniation in group I; ligamenta flava hypertrophy was more common at L3-L4 and L4-L5 levels of vertebrae in females.ConclusionsAetiology of contralateral sciatica among disc herniated patients may be related to hypertrophy of the ligamenta flava, especially on the opposite side. Surgical approaches of the disc herniated side alone may be sufficient for a good outcome.

Objective. To investigate the indications to receive brain computed tomography (CT) scan and to define the pathological findings in children younger than three years of age with minor head trauma in emergency departments. Methods. In this study, hospital case notes of 1350 children attending the emergency department of Bitlis State Hospital between January 2011 and June 2013 were retrospectively reviewed. 508 children under 3 years of age with minor head trauma were included in this study. We also asked 37 physicians about the indications for requiring CT in these children. Results. This study included 508 children, 233 (45,9%) of whom were female and 275 were male. In 476 (93,7%) children, the brain CT was completely normal. 89,2% of physicians asked in the emergency department during that time interval reported that they requested CT scan to protect themselves against malpractice litigation. Conclusion. In infants and children with minor head trauma, most CT scans were unnecessary and the fear of malpractice litigation of physicians was the most common reason for requesting a CT.

Aim: Epidural fibrosis, which develops after spinal surgery, is one of the factors which reduce the chances of successful surgery in the medium and long term by tightly surrounding the dura and spinal roots. In this experimental study, the aim was to compare the effects of local and systemic administration of dexpanthenol on epidural fibrosis formation in rats. Methods: Twenty-eight rats were randomly divided into 4 equal groups (control, Spongostan, local dexpanthenol and systemic dexpanthenol) and laminectomy was performed at the T11 level. Local dexpanthenol (500mg/kg) was administered with Spongostan, and systemic dexpanthenol (500 mg/kg) was administered once a day for three weeks. Epidural fibrosis, arachnoidal involvement, fibroblast cell count, vascular endothelial growth factor, and hydroxyproline levels were evaluated. Results: The grade of epidural fibrosis, fibroblast cell counts, and hydroxyproline levels were significantly lower in the systemic dexpanthenol groups (P=0.025). Conclusion: Dexpanthenol may be used as potential agent for reducing epidural fibrosis. However, it should be administered more than once for it to take effect.