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Aneurysmal bone cyst (ABC) is a locally agressive tumor-like lesion of the bone. Sacral location is rare. Currently recommended treatment for a benign ABC lesion is complete intralesional curettage with or without selective arterial embolization and attempt to salvage unilateral sacral 2-5 roots. A 14-year-old girl presented with severe pain and a large mass in her lower lumbosacral region. Imaging studies demonstrated a destructive lesion, arising from the second sacral vertebral level, extending posteriorly and bilaterally into the gluteal muscles, and anteriorly into the pelvis. Open biopsy established the diagnosis of ABC. Marginal extra-capsular resection via a combined anterior and posterior approach, and postoperative radiation therapy were performed. The patient was pain-free, and no evidence of local recurrence was detected at the 84-month follow up postoperatively. Marginal extra-capsular resection and adjuvant radiotherapy are thought to be effective for the treatment of this large ABC of the sacrum. © 2010 by Türkiye Klinikleri.

Amaç: Çalışmanın amacı, yapısal kalp hastalığı olmayan olgularda, sağ ventrikül apikal pacing ile ortaya çıkan ventriküler aktivasyon sekansı değişikliğinin, her iki ventrikülün sistolik ve diyastolik fonksiyonları üzerine olan akut etkisinin ekokardiyografi ve radyonüklid ventrikülografi (RVG) ile değerlendirilmesidir. Yöntem: Hasta sinüs sendromu (HSS) nedeni ile iki odacıklı kalp pili taşıyan 17 hasta çalışmaya dahil edildi. Çalışmaya alınan tüm olgular normal atriyoventriküler (AV) iletiye sahip, intrinsik ileti sırasında dar QRS izlenen ayrıca ventriküler elektrodun sağ ventrikül apeksinde konumlandırıldığı hastalardı. Tüm hastalara öncelikle AAI modunda (Mod 1) 5 dakika sonra da DDD modunda (Mod 2- mümkün olan en kısa AV interval ile % 100 ventriküler pacing sağlayarak) ekokardiyografik inceleme ve RVG yapıldı. Her iki pil modu sırasında sol ve sağ ventrikül için diyastol ve sistol sonu volümü, ejeksiyon fraksiyonu (EF), miyokardiyal performans indeksi ile inter- ve intraventriküler dissenkroni indeksleri ölçüldü. Bulgular: Sol atriyum çapı Mod 2’ de Mod 1’ e kıyasla anlamlı olarak daha büyüktü (37,1 ± 3,9’ a karşılık 35,5 ± 2,4 p=0,014). Ekokardiyografi ve RVG ile ölçülen sol ventrikül diyastol sonu volümü (SVDSV) Mod 2 sırasında Mod 1’ e göre anlamlı olarak daha düşüktü (96,3 ± 10,9’ a karşılık 110,8 ± 18,6; p=0,017 ve 94 ± 11’ e karşılık 104,3 ± 11,6; p=0,02). Benzer şekilde ekokardiyografi ve RVG ile hesaplanan atım volümü ve EF Mod 2 sırasında Mod 1’ e kıyasla anlamlı olarak daha düşük saptandı (53,2 ± 9,4’ e karşılık 64,2 ± 11,3; p=0,008, 43,8 ± 6,3’ e karşılık 54,9 ± 7,2; p=0,004 ve % 55,1 ± 5,1’ e karşılık % 59,1 ± 4,5; p=0,003, % 46,8 ± 7,4’ e karşılık % 52,9 ± 7,3; p=0,008). Triküspit lateral anulusundan ölçülen MPİ değeri iki pil modu arasında benzerken (0,46 ± 0,14’ e karşılık 0,47 ± 0,12; p=0,71), mitral lateral anulustan Mod 2 için ölçülen MPİ değeri, Mod 1’ e göre anlamlı olarak daha yüksek bulundu (0,51 ± 0,06’ ya karşılık 0,42 ± 0,05; p=0,001). Mod 1 ve Mod 2 sırasında ölçülen tricuspid annular plane systolic excursion (TAPSE) değerleri benzerdi (21,8 ± 2,3’ e karşılık 20,9 ± 1,1; p=0,13). Sol ventrikül elektromekanik gecikme değeri, interventriküler elektromekanik gecikme değeri ve interventriküler dissenkroni değeri Mod 2’ de Mod 1’ e kıyasla anlamlı olarak daha uzundu (73,4 ± 28,5’ e karşılık 23,4 ± 12; p

Psikotarih, tarihle psikolojiyi buluşturan yeni bir disiplindir. Hattâ tarihi şahsiyetlerin psikolojisi olarak tanımlanabilir. Psikotarih ülkemizde henüz pek bilinmemektedir. Bu bilim dalı, insanın psikolojik motivasyonlarını anlamak için psikanalitik yaklaşımları kullanmaya çalışmaktadır. Acaba gerçekten psikanalistler kaynakların ve tarihçilerin sağladığı veriler ışığında tarihi şahsiyetlerin psikolojilerini çözmeyi başarabilirler mi? Meselâ Cengiz Han’la (1162?-1227) soyu, yetiştiği ortam, kişiliği ve yasası arasında bir ilgi kurmak mümkün müdür? İşte bu makale bu soruların cevaplarına ulaşmayı denemektedir. Bu bağlamda, Temucin’in klandan imparatorluğa geçiş sürecinde hayatının ilk evrelerinde yaşadığı olayların ileriki hayatındaki izleri takip edilmiş ve şaşırtıcı bazı etkileşimlere dikkat çekilmekle yetinilmiştir, Psychohistory is a new discipline that combines psychology with history. It can even be described as the psychology of historical figures. Psychohistory, is hasn’t been known much yet in our country. This branch of science, tries to use of the psychoanalytic ap- proaches for understanding the human's psychological motivation. I wonder whether psychoanalysts can manage to solve the psychology of the historical figures in the light of the data provided by historians and historical resources. This study focuses on an impor- tant figure, Temucin [later Chinggis Khan (1162?-1227)] and his origin of family and an- cestors, his growth neighborhood and geographical environment, childhood, personality and his law (Yasa), the famous. Is there any relation between Chinngis Khan and them? In this sense, it has been tried to highlight the tracks of Temucin’s early experiences during his childhood and adulthood and influences of these experiences to his decisions and be- haviors when he became the Khan of Mongols (King of them). The purpose of this article is to reach the answers of these questions

In this study the effect of heat treatment on air-dry density (Dm), oven-dry density (D0), shrinkage (), swelling (), fiber saturation point (FSP), compression strength parallel to grain (c//), bending strength (b), modulus of elasticity (MOE) in bending, Brinell-hardness (HB), equilibrium moisture content (EMC), chemical content and cellulose crystallinity of Anatolian black pine [Pinus nigra J.F. Arnold subsp. nigra var. caramenica (Loudon) Rehder] was evaluated. Specimens were subjected to heat under atmospheric pressure at 3 different temperature (130, 180 and 230°C) and 2 different time levels (2 and 8 h). The value of Dm, D0, , , FSP, EMC, c//, b, MOE, holocellulose, 1% NaOH and alcohol solubility decreased, whereas, lignin content increased depending on the heating temperature and the time. Cellulose crystallinity of the specimens was not changed significantly. 130°C showed minimum effect, on the other hand, 230°C showed maximum effect on all properties of treated wood. Accordingly, for heat treatment process, 130°C for 2 h should be applied in place where mechanical properties are important. However, 230°C for 2 h should be used in place where a physical property is preferred.Consequently, heat treated Anatolian black pine woods could be utilized in applications for several purposes such as kitchen furniture, outdoor furniture and windows frames.

In this study, %100 combed ring, compact, open end rotor and vortex (MVS) yarns with different yarn counts, which were used from the same raw material blend were produced and wound to same package density according to the principle of loose winding and the physical properties of the yarns were tested. The bobbins were dyed with reactive dye for different three dyebath concentration in the universal package dyeing machine and were dried with a high frequency drier. Single jersey knitted fabrics was produced using same machine parameters on the sample circular knitting machine and bending resistances were measured by the digital pneumatic stiffness tester. The test results were analyzed by using statistical methods. in the results of analysis of variance, spinning system and yarn number were found as significant at significance level (Sig. p

The 2006 campaign of surveys in Adana was conducted by Höyük and Settlement Identification group under our coordination and within the framework of the Cilician Surveys led by Prof. Dr. Mustafa H. Sayar of İstanbul University. We would like to express our thanks for his close collaboration.

This article is based upon the assumption that the European Union has a goal of resolving certain problems pertaining to globalization that its members face, and that Turkey views the membership procedure as a solution of such problems. The awakening sub-identities and the erosion of dividing borders are causing nation-states to face a series of problems concerning sovereignty and identity, such as ontological security and identity fragmentation. To solve such problems, the nation-states compromise their single-centered and assimilationist identity management policies in favor of multi-centered identity governance. With identity governance, not only the national governments, but also the local authorities and the European Union have word on identity issues. Identity governance, despite dwindling sovereign rights, is performed successfully within the European Union, and is recommended to the Turkish government. From Turkey's side, as a solution to the problem of identity fragmentation, the membership process provides a common, unifying and shared goal for groups with different identities.

Ankilozan spondilitte omurgayı oluşturan kemik ve bağ yapı- lardaki kırılganlık sonucu küçük travmalarda bile omur kırığı oluşabilir. Kırıklar sıklıkla torakolomber bölgede, nadiren servikal bölgede meydana gelir. Bu yazıda ankilozan spondiliti olan ve yüksekten düşme sonrası alt ekstremitede güçsüzlük ve yürüme güçlüğü şikayetleriyle kliniğimize başvuran 52 yaşında erkek hasta sunuldu. Nörolojik muayenede giderek artış gösteren motor fonksiyon kaybı vardı. Manyetik rezonans görüntülemede servikal beşinci ve altıncı omurlar seviyesinde Chance kırığı saptandı. Ameliyatta tek seanslı anterior füzyon, stabilizasyon ve posterior dekompresyon yapıldı. Ameliyat sonrası nörolojik tabloda giderek artan düzelme görüldü. Hasta ameliyat sonrası yedinci günde akciğer yetersizliği nedeniyle kaybedildi., Spinal fractures can occur after minor traumas due to the fragility of osseous or ligamentous structures of the spine in patients with ankylosing spondylitis. They are usually seen in the thoracolumbar region of the spine. However, the cervical region is an extremely rare location for these fractures. We present a 52-year-old male with ankylosing spondilitis who had complaints of weakness in the lower extremities and difficulty with walking after a fall from height. Neurologic examination revealed a progressive loss of motor function. Magnetic resonance imaging showed a Chance fracture at the fifth and sixth cervical vertebrae. We performed a one-stage anterior cervical fusion and stabilization with posterior decompression. Postoperatively, there was a progressive neurologic improvement. However, the patient died due to pulmonary failure at the seventh day postoperatively.

Purpose. An increased intima-media thickness (imt) in the carotid arteries is a marker of generalized atherosclerosis, and it has been associated with a high risk of stroke. The aim of this study was to investigate whether patients with obstructive sleep apnea syndrome (OSAS) have an increase in atherosclerotic indicators in the carotid arteries. Methods. We studied 30 men with severe OSAS who had an apnea-hypopnea index (AHI) of at least 20. IMT measurement and the presence of stenotic occlusive lesions in the carotid arteries (right common carotid artery [RCCA], right bulb [RbuIb], right internal carotid artery [RICA], left common carotid artery [LCCA], left bulb [LbuIb], and left internal carotid artery [LICA]) were investigated by high-resolution sonography. Results of the sonographic examinations were compared with those for a group of 20 subjects with mild OSAS (AHI < 20) and 20 healthy subjects. Results. The mean IMT of the carotid arteries of patients with severe OSAS was significantly higher than those of patients with mild OSAS and control subjects (RCCA 0.81 versus 0.63 versus 0.58, p < 0.01; Rbulb 0.96 versus 0.87 versus 0.65, p < 0.001; RICA 0.77 versus 0.69 versus 0.61, p < 0.05; LCCA 0.97 versus 0.78 versus 0.67, p < 0.01; Lbulb 1.01 versus 0.89 versus 0.72, p < 0.01; LICA 0.91 versus 0.75 versus 0.65, p < 0.001). Conclusions. This study shows that the carotid arteries' IMT is increased in patients with severe OSAS. This increase may predispose the patients to cerebrovascular disease. Additionally, the findings support the hypothesis that patients with OSAS are at risk of developing cerebrovascular disease regardless of the presence or absence of other vascular risk factors (eg, hypercholesterolemia, diabetus mellitus, and hypertension). © 2005 Wiley Periodicals, Inc.

Amaç: Hemivertebra nadir görülen ve skolyoza sebeb olabilen bir spinal anomalidir. Cerrahi tedavisinde tek başına posterior girişim ile hemivertebrektomi yeni, efektif ve konvansiyonel yöntemlere göre daha az invazifdir. Olgu sunumu: 20 aylık erkek bir çocukta lomber 2’de tam segmentleşmiş hemivertebra ve buna bağlı progresif skolyoz nedeniyle yalnız posterior girişim kullanılarak hemivertebrektomi yapıldı. Sonuç: Postoperatif dönemde hem sagittal ve hem de koronal planda tam korreksiyon sağlandı. On iki aylık takiplerinde ciddi korreksiyon kaybı saptanmadı. Posterior girişimle hemivertebrektomi; konvansiyonel hemivertebra cerrahisine gore minimal invazif bir girişim olup, deformitenin 3 boyutlu korreksiyonunda oldukça etkili bir yöntemdir., Objective: Hemivertebra is a rare spinal anomaly that lead to scoliosis. Posterior approach is an innovative and effective method in the surgical treatment of hemivertebra without combined with anterior approach. Case report: 20 months old boy with fully segmented hemivertebra at the second lumbar vertebra causing progressive scoliosis underwent to a posterior hemivertebrectomy approach. Conclusion: Postoperatively complete correction was obtained in both coronal and sagittal plan. No severe correction loss had seen at follow-up of 12 months. Posterior approach when compared with conventional methods for hemivertebrectomy is a minimally invasive and a very effective method to obtain three dimentional correction of the deformity.

We present the case of a 37-year-old woman with a history of 2 consecutive insertions of intrauterine contraceptive devices (IUDs) 3 years before she was referred to us for sonographic evaluation of lower abdominal pain. The first of the IUDs was presumed to have been expulsed spontaneously, and 3 months after insertion of the second device, the patient had begun experiencing lower abdominal pain. Medical treatment with antibiotics and spasmolytics had been unsuccessful. We performed transvaginal sonography, which revealed the presence of an IUD in the uterus and a 2-cm linear metallic echogenic area in the left ovary, believed to represent another IUD. Anteroposterior radiography confirmed that there were 2 IUDs in the pelvis, and CT demonstrated 1 IUD in the uterus and another in the left ovary. The patient underwent laparoscopic removal of the ovarian IUD and was discharged in good condition. To our knowledge, this is the first report of migration of an IUD to the ovary detected on transvaginal sonography. We recommend consideration of this possibility during evaluation of women with unexplained chronic pelvic pain. © 2004 Wiley Periodicals, Inc.

Congenital arteriovenous fistula of the hand is uncommon. We report a case of unusual congenital arteriovenous fistula forming multiple fistulous communications between the arteries and veins in the right hand. Clinical findings were confirmed by color Doppler sonography and digital subtraction angiography. © 2004 Wiley Periodicals, Inc.

We reviewed 27 patients with a minimally displaced proximal humeral fracture treated conservatively after a mean follow-up of 25 (12-34) months. All fractures had united. Patients were evaluated using the Constant-Murley scoring system, and isokinetic muscle strength was tested using a Cybex dynamometer. Finally, all shoulders were examined ultrasonographically. The mean Constant score for all patients were 81 (54-100). Twenty-three patients had no or only mild pain, while three had moderate and one severe pain necessitating regular use of oral analgesics. Twenty patients were able to perform all activities of daily living, but seven had mild trouble in overhead activities and weight carrying. Only in one patient, the abduction peak torque equalled the one of the opposite shoulder. In all other patients, the peak torque was lower than, and in 14 patients below, 50%. In nine patients, rotator cuff tears were seen at ultrasonography.

AMAÇ Önkolda kombine sinir-tendon lezyonu olan olgularda yapılan sinir tamirinin klinik ve fonksiyonel sonuçları değerlendirildi. GEREÇ VE YÖNTEM Önkolda kombine sinir ve tendon kesişi saptanan 68 hasta (58 erkek, 10 kadın; ort. yaş 33.5; dağılım 5-48) retrospektif olarak incelendi. Olgularda uygulanan periferik sinir tamiri sayısı 96 idi. Sinir defekti olan hastalar çalışmaya alınmadı. Yaralanma, 17 hastada median ve ulnar sinirde, 17 hastada median, 34 hastada ulnar sinirdeydi. Hastalar, yaralanmadan ortalama dört saat (dağılım 20 dakika-24 saat) sonra ameliyata alındı. Altmış hastada primer sinir tamiri, sekiz hastada sekonder tamir uygulandı. On sekiz hastada interfasiküler dikiş, 50 hastada epiperinöral dikiş tekniği kullanıldı. Tüm hastalara ameliyat sonrası dönemde Washington rejimi ile rehabilitasyon uygulandı. Hastalar, fonksiyonel değerlendirme yöntemlerini içeren modifiye MRC (Medical Research Council) sınıflandırması ile değerlendirildi. Takip süresi en az iki yıl idi. Modifiye MRC sonuçları, yalnız median sinir kesişi olan 17 hastanın 10'unda çok iyi, yedisinde iyi; yalnız ulnar sinir kesişi olan 34 hastanın dokuzunda mükemmel, 10'unda çok iyi, 10'unda iyi, beşinde zayıf; median ve ulnar sinir kesişi tamiri yapılan 17 hastanın dördünde mükemmel, yedisinde çok iyi, altısında iyi bulundu. Altmış bir hastada (%89.7) tatmin-kar sonuç elde edildi. Yaş ile MRC sonuçları arasında anlamlı ilişki bulundu (p0.016). SONUÇ Önkol kombine sinir-tendon kesilerinde primer tamir ve erken hareket ile büyük oranda mükemmel ve tatmin edici sonuç elde edilebilmektedir., BACKGROUND We evaluated the clinical and functional results of nerve repair in patients with combined tendon-nerve injuries of the forearm. The study included 68 patients (58 males, 10 females; mean age 33.5 years; range 5 to 48 years) with combined tendon-nerve injuries of the forearm. A total of 96 nerves were repaired. Patients with nerve defects were excluded. Both median and ulnar nerves were injured in 17 patients; median and ulnar nerve injuries were detected in 17 patients and 34 patients, respectively. The mean time to operation was four hours (range 20 nün to 24 h). Primary nerve repair was performed in 60 patients, and secondary repair was performed in eight patients. The interfascicular technique was employed in 18 patients, and epiperineural suture in 50 patients. Rehabilitation included early motion using the Washington regimen. A modified MRC (Medical Research Council) motor and sensory classification system was used for postoperative evaluation. The mean follow-up was at least two years. The modifıed MRC results were as follows: of 17 patients with median nerve injuries, 10 had excellent, seven had good results. Of 34 patients with ulnar nerve injuries, the results were excellent in nine, very good in 10, good in 10, and fair in fıve patients. Of those with median and ulnar nerve injuries, four, seven, and six patients had excellent, very good, and good results, respectively. Overall, 61 patients (89.7%) had satisfactory results. A significant correlation was found between age and the MRC results (p0.016). Primary nerve repair follovved by early motion results in substantial rates of excellent and satisfactory results in patients with combined nerve-tendon injuries.

Pseudoaneurysm of the dorsalis pedis artery is an uncommon condition that is usually caused by a traumatic injury or an iatrogenic intervention. The patient usually complains of an enlarging painless, pulsatile mass. A tentative diagnosis may be made by palpation of the pulsatile mass and detection of an associated systolic bruit. Color Doppler sonographic and arteriographic examinations can be used to confirm the diagnosis. We report the case of a 17year-old patient with a posttraumatic pseudoaneurysm of the dorsalis pedis artery. Sonographic examinations revealed pulsatile flow into and out of a cystic structure surrounded by a thick hypoechoic wall and a "to-and-fro" pattern in the neck of the vascular mass; these findings were consistent with the diagnosis of a pseudoaneurysm. Angiography confirmed the diagnosis. The patient was treated with ligation of the artery and resection of the pseudoaneurysm. He recovered well after surgery and remained free of symptoms 3 months postoperatively. We believe that color Doppler sonography should be the procedure of choice for use in diagnosing pseudoaneurysms; arteriography can then be used to evaluate the alternative blood supply before surgery is undertaken. © 2003 Wiley Periodicals, Inc.

İliak boynuzlar oldukça nadir görülen kemik varyasyonlarıdır. Klinik olarak bu tip varyasyonlar kemiğin benign ve malign pekçok hastalıkları ile karışabilmektedir. İliak bonuzlar en sık olarak herediter bir hastalık olan Tırnak-patella sendromunda görülmektedir. Bu çalışmada; anatomik kemik pasajlarında yapılan incelemelerde saptanan 3 iliak boynuzun anatomo-morfolojik özellikleri ve eşlik ettiği patolojiler ortopedik yönden değerlendirildi., Iliac horns are very rare bone variations. This variation confused with benign and malign disease of the bone in both clinical and radiological point of view. The majority of the iliac horns are associated with hereditery Nail-patella syndrome. Three iliac horn were found in anatomic bone survey. And we evaluated anatomomorphologic characteristics of the iliac horns and its orthopaedic associations.

Unilateral congenital agenesis of the internal carotid artery (ICA) is a very rare vascular anomaly. Rarely, congenital Horner's syndrome has been associated with agenesis of the ICA. This article describes a rare case of congenital Horner's syndrome in a patient with ICA agenesis and very unusual aortic arch anomaly.

Migration of an intrauterine contraceptive device (IUD) to the urinary bladder is very rare. We describe a case in which transabdominal sonography demonstrated such migration of an IUD in a 30-year-old woman who sought treatment for pelvic pain and dysuria. The IUD had originally been inserted 10 years earlier, and the patient had given birth without complications 2 years before the onset of her symptoms. Cytoscopic examination confirmed the diagnosis and allowed removal of the IUD. © 2002 Wiley Periodicals, Inc.

ÖZET Bu çalışma mesleki tükenmişlik düzeylerini belirlemek amacı ile Maslach Tükenmişlik Ölçeği kullanılarak Cumhuriyet Üniversitesi çalışan 131 öğretim elemanı üzerinde yapılmıştır. Araştırmamızda Cumhuriyet Üniversitesinde çalışan farklı statüdeki akademik personelde; akademik unvanlarının farklı olması, evli ya da bekar olmak, meslekte toplam çalışma süresi, aylık gelir düzeyini yeterli görüp görmemeleri, sigara ya da alkol kullanmak ve dereceleri duyarsızlaşma, kişisel basan ve duygusal tükenme puanlan karşılaştınldığında farklılık istatistiksel olarak önemsiz (anlamsız) bulunmuştur. Araştırmamız deneklerinde; kadın ya da erkek olmak, mümkün olsa mesleğini değiştirmeyi isteyip istememek, belirttikleri zor yaşam olaylan ve mesleği ne kadar süre yapmak istediklerine göre Maslach Tükenmişlik Ölçeği alt testleri açısından anlamlı farklılık göstermiştir. Bu çalışma kapsamında aynca tükenmişlik sendromu ile ilgili bazı değişkenlerin etkileri incelenmiştir. Bulgular bireysel değişkenlerden daha çok, ortamla ilgili değişkenlerin önemli olduğu sonucunu vermiştir. Akademik personelin önemli iş tükenmişlik düzeyleri yaşadıklan ve görev ünvanlan açısından iş tükenmişlik düzeylerinin farklı olacağına dair hipotezlerimiz desteklenmemiştir. Bu çalışmanın sınırlı bir örneklem ile yürütüldüğü göz önüne alınarak, sonraki araştırmalarda, farklı sosyo-demografik ve bölgesel özelliklerde yaşayan daha geniş örneklem üzerinde çalışılmasının daha farklı sonuçlar elde edilmesine sebep olabileceği görüşündeyiz. XI SUMMARY This study investigated the professional burnout level of 131 faculty members of Cumhuriyet University by adapting Maslach Burnout Scale. Emotional exhaustion, depersonalization and personal accomplishment's scores of Cumhuriyet University faculty have shown that differences in Academic title, to be married or not, total working period in profession, to be satisfied with salary or not, the level of smoking or taking alcohol have no meaningful statistical relation with the professional burnout level. Maslach burnout scores have shown that the professional burnout has a meaningful relation with the group of faculty who are either male or female, who wants to change or not to change his/her profession if it was possible, time period to continue his/her profession. Within the scope of this study, the effect of some variables related to burnout syndrome has been investigated. The findings showed that environmental variables are more important than variables related to his/herself. Professional burnout level of academic people did not support our hypothesis, which was that the level of professional burnout would be different for the people who have different academic title. This study was completed with a limited number of people. However, we think that further studies considering people living in area having different socio demographic and regional characteristics will present different results. 246

ÖZET: Bu tez çalışmasında, Ankara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji anabilim dalında, mart 1991 ile mayıs 1998 yıllan arasında torakolomber anterior dekompresyon+instrümentasyon+füzyon uygulanan; 48 travma, 28 Pott Hastalığı ve 14 tümör vakası olmak üzere toplam 90 hasta değerlendirildi. Retrospektif bu tez çalışması ile omurilik basısına sebep olan ve sık rastlanan spinal travma, Pott Hastalığı ve spinal tümör gibi etyolojiler hakkında detaylı bilgiler verilirken, bu durumlardaki cerrahi tedavi endikasyonları ve tekniği; kendi serimiz ile birlikte literatür ışığında sunulmuştur. Tüm 90 hastanın; özellikle klinik olarak nörolojik durumu ile radyolojik olarak spinal kanal stenozu, preoperatif ve postoperatif olarak birden değerlendirilecek olursa; klinik olarak en az iki Frankel Grade' inde ilerleme ve radyolojik olarak bazılarında tama yakın kanal temizliğinin sağlanması anterior epidural basılarda veya anterior kanal içi patolojilerinde anterior girişimin efektifliğini gösterirken, postoperatif korreksiyon oranları bize dekompresyon ve füzyon sonrasında bazı seçilmiş vakalar dışında anterior instrümentasyonun mutlak zorunluluğunu ortaya koymaktadır. Tüm bunlar, uygun endikasyon ve iyi bir cerrahi teknik ile yapılan anterior girişimlerin sonuçlarının posterior girişimlerden daha üstün olduğunu göstermektedir. Ancak tüm bunlara rağmen, TLADİF girişimleri yine de major bir cerrahi uygulamaları içindedir. Bu nedenle, bu girişimlerde yapılan tüm manipülasyonların artık yavaş yavaş endoskopik cerrahi ile de mümkün olmasından dolayı, açık Torakolomber Spinal Anterior cerrahinin geleceğinin endoskopik cerrahi olacağı kanaatindeyim. 143

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