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Objective: This study aimed to evaluate the clinical and radiological outcomes of patients undergoing transpedicular screw and polyetheretherketone (PEEK) rod stabilization for the surgical treatment of degenerative diseases of the lumbar spine. Materials and Methods: A retrospective analysis was conducted on 51 patients diagnosed with degenerative spine disease, such as recurrent disc herniation, spinal stenosis, spondylolisthesis, and adjacent segment disease, who underwent bilateral transpedicular screw-PEEK rod stabilization between May 2017 and November 2020. Preoperative and postoperative assessments included lumbar lordosis angles, sacral slope, pelvic incidence, pelvic tilt, visual analog scale (VAS) scores, PROLO economic and social scores, and the presence of adjacent segments and fusion. Results: The study included 51 patients with a mean age of 62.5 years (range: 18-85 years), with 56.8% (29 patients) being female and 43.2% (22 patients) being male. Surgical procedures involved single-level stabilization in 16 patients, two-level stabilization in 21 patients, three-level stabilization in 9 patients, and four-level stabilization in 5 patients. The mean follow-up period was 52.4 months. Postoperatively, there was a significant reduction in VAS scores from a mean of 8.2±1.3 to 3.4±1.7 (p«0.01). No significant changes were observed in the lumbar lordosis angle, sacral slope, pelvic tilt angle, and pelvic incidence angle. The mean PROLO score improved from 3.5±1.2 preoperatively to 7.6±1.5 postoperatively. Fusion was observed in 43 patients during the follow-up period. Conclusion: The use of PEEK rods in the surgical treatment of degenerative lumbar spine diseases may lead to improved postoperative quality of life and reduced implant-related complications. Furthermore, our findings suggest that patients without sagittal balance impairment may benefit from PEEK rod stabilization without significant changes in spinal alignment. However, further comparative and long-term studies are required to better understand the efficacy and outcomes of PEEK rod systems in this treatment approach. [ABSTRACT FROM AUTHOR]

Objective: Spinal metastases are the most common tumors of the spine, constituting approximately 90% of masses encountered on spinal imaging. Spinal metastases are more commonly found as bone metastases, but are not limited to bone metastases, and approximately 20% present with symptoms of spinal canal invasion and cord compression. Materials and Methods: A total of 32 patients who were operated for spinal bone metastases in our clinic between April 2020 and April 2022 were examined retrospectively with digital file records and imaging. Results: Of the 32 patients included in our study, 5 (15.6%) were operated for cervical, 21 (65.6%) for thoracic, 8 (25%) for lumbar, 2 (6.25%) for sacral spinal bone metastases. There were multiple metastases in 7 (21.8%) patients. Twenty of the patients (62.5%) were male and 12 (37.5%) were female. The mean age was 67.3±13.8 years. According to the Tomita scoring, the mean was 4,8 (minimum 2-maximum 7). When the Frankel scoring of the patients was performed, 6 (18.75%) patients were B grade, 1 (3.1%) patient was C grade, and 25 (78.1%) patients were E grade. Patients with a Spinal Instability Neoplastic Score (SINS) value above 7 were considered suitable for surgery. In our study, the mean SINS was 11.1 (minimum 7, maximum 17). All patients were evaluated according to the neurologic, oncologic, mechanical, and systemic (NOMS) framework. Patients who were not suitable for surgery according to the NOMS evaluation were referred for radiotherapy/chemotherapy and weren't included in the study. Conclusion: The decision-making process is difficult in patients with metastatic spinal disease. The surgeon must take into consider the purpose of the intended surgery (to counteract pain and preserve or restore neurological function) and the physical ability of each patient to withstand such a surgery. [ABSTRACT FROM AUTHOR]

Objective: Pathologic vertebral fractures are most commonly caused by osteoporosis, and kyphoplasty is one of the most common minimally invasive surgical treatments. In osteoporotic vertebral fractures, the underlying pathology may not be recognized. Therefore, a needle biopsy may be essential during kyphoplasty. This study investigated the incidence of unsuspected malignancies in patients undergoing kyphoplasty for osteoporotic vertebral fractures. Materials and Methods: Data from 56 patients (29 women, 27 men) who underwent kyphoplasty and had needle biopsy were retrospectively reviewed. Patients in whom no bone biopsy was performed and those in whom kyphoplasty was performed for reasons other than osteoporosis were excluded from the study. Patients who did not experience relief after medical treatment and who had a visual analog scale score of 6 were included in the study. Results: Five patients not suspected to have malignant disease were diagnosed with malignancy after pathological examination. Two of them were thought to have metastases from a primary tumor (one breast cancer and one prostate cancer). The incidence of unexpected malignancy was 8.9%. Conclusion: Percutaneous needle biopsy is a low-cost highly effective method. Therefore, we recommend routine needle biopsy during kyphoplasty. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is the second most common cause of death (85%) worldwide. In addition, stroke patients with good nutritional parameters have a lower risk of death and earlier discharge from the hospital. In our study, we evaluated nutritional and other factors affecting intensive care mortality in stroke patients followed in the general intensive care unit. Materials and Methods: The data of 239 hemorrhagic and ischemic stroke patients followed in general intensive care units following ethics committee approval were evaluated retrospectively. Nutritional, sociodemographic and clinical characteristics of patients with hemorrhagic and ischemic stroke were compared and the effects of these characteristics on mortality were evaluated. Results: Comparisons of patients with hemorrhagic - ischemic stroke and stroke patients who lived and died was given in Table 1. Results of univariate and multivariate cox regression analysis performed to determine risk factors affecting intensive care mortality was given in Table 2. In the univariate model, stoke type, CPR (cardio-pulmonary resuscitation) requirement during intensive care stay, feeding time rate, nasogastric requirement, oral nutritional status, chronic kidney disease and APACHE II were statistically significant. In the multivariate model, the need for CPR, oral nutritional status, and APACHE II were statistically significant during ICU admission (respectively, p=0.032, p<0.001, p<0.001). Mortality risk was 14.8 times higher in patients who could not be fed orally than in patients who were fed orally. It was determined that a one-unit increase in the APACHE II score increased the mortality risk 1.07 times. Conclusion: We can say that mortality will decrease in stroke patients who can be fed orally, have a low APACHE II score, and do not need CPR during intensive care follow-up [ABSTRACT FROM AUTHOR]

Objective: Lumbar disc herniation (LDH) is a socio-economic burden. The physiopathology of the disease is not clarified completely. This study aimed to investigate the oxidation-reduction balance in LDH via serum thiol-disulfide and ischemia-modified albumin (IMA) levels. Materials and Methods: This prospective case-control study included 30 patients with LDH and a control group with 30 healthy volunteers. Blood samples were analyzed for total thiol (-SH+ -S-S-), native thiol (-SH), and IMA levels. Disulfide levels and native thiol/total thiol ratio were calculated. The results of the two groups were compared. Results: Native and total thiol levels were significantly higher in the LDH group than in the control group (p=0.007 and p=0.008, respectively). IMA levels were significantly higher in the LDH group than in the control group (p=0.000). The receiver operating characteristic curve demonstrated that the IMA value of 1.41 could predict the LDH with 80% sensitivity and 80% specificity (area under curve=0.888, confidence interval: 0.802-0.974). Conclusion: LDH influences the thiol-disulfide balance, and increased IMA levels can predict LDH. [ABSTRACT FROM AUTHOR]

Objective: Injury of the spinal cord is studied in two separate mechanisms as primary and secondary injuries. During the secondary injury, spinal cord damage and related neurological defects could increase mostly because of oxidative damage. Treatments targeting this process are promising for reducing neuronal damage. Ganoderma lucidum (GL) has the potential to suppress the inflammatory response and oxidative stress. The aim of this study is to determine the neuroprotective effect of traditional GL hot-water extract during the secondary spinal cord injury (SCI) period on an experimental rat spinal trauma model by measuring the biochemical parameters. Materials and Methods: A total of 34 rats were distributed randomly into 4 groups as trauma, vehicle, low-dose medication group (low-DMG) and high-dose medication group (high-DMG). A modified Walsh-Tator clip was applied extradurally to form an experimental SCI model. GL liquid extract was performed in medication groups with low and high (10 times higher) oral doses. Spinal cord specimens were collected after 5 days of treatment for biochemical analysis. Results: In the low-DMG, both diphenypicrylhydrasyl (DPPH) and malondialdehyde (MDA) values were found statistically negligible when compared with the trauma group. Comparison of the Low-DMG and vehicle group showed a significant change in DPPH value, but an insignificant change in MDA value. A statistically significant positive change in both DPPH and MDA values was found in High-DMG when compared to trauma and vehicle groups. Conclusion: Prevention of secondary SCI is very important, since the neurological condition of the patients may get worse during this period. Dose-dependent positive results were obtained in the favor of GL in terms of both antioxidant efficacy and prevention of lipid peroxidation after SCI. The results of this biochemical study is supporting the previous studies and showing that GL has the potential of reducing posttraumatic oxidative damage in the spinal cord when given at the appropriate dose. [ABSTRACT FROM AUTHOR]