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    Co-occurrence of lumbar spondylolysis and lumbar disc herniation with lumbosacral nerve root anomaly
    (Medknow Publications & Media Pvt Ltd, 2014) Yilmaz, Tevfik; Turan, Yahya; Gulsen, Ismail; Dalbayrak, Sedat
    Lumbosacral nerve root anomalies are the leading cause of lumbar surgery failures. Although co-occurrence of lumbar spondylolysis and disc herniation is common, it is very rare to observe that a nerve root anomaly accompanies these lesions. A 49-year-old male patient presented with sudden-onset right leg pain. Examinations revealed L5/S1 lumbar spondylolysis and disc herniation. At preoperative period, he was also diagnosed with lumbosacral root anomaly. Following discectomy and root decompression, stabilization was performed. The complaints of the patient diagnosed with lumbosacral root anomaly at intraoperative period were improved at postoperative period. It should be remembered that in patients with lumbar disc herniation and spondylolysis, lumbar root anomalies may coexist when clinical and neurological picture is severe. Preoperative and perioperative assessments should be made meticulously to prevent neurological injury.
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    Decreased Vertebral Artery Hemodynamics in Patients with Loss of Cervical Lordosis
    (Int Scientific Information, Inc, 2016) Bulut, Mehmet Deniz; Alpayci, Mahmut; Senkoy, Emre; Bora, Aydin; Yazmalar, Levent; Yavuz, Alpaslan; Gulsen, Ismail
    Background: Because loss of cervical lordosis leads to disrupted biomechanics, the natural lordotic curvature is considered to be an ideal posture for the cervical spine. The vertebral arteries proceed in the transverse foramen of each cervical vertebra. Considering that the vertebral arteries travel in close anatomical relationship to the cervical spine, we speculated that the loss of cervical lordosis may affect vertebral artery hemodynamics. The aim of this study was to compare the vertebral artery values between subjects with and without loss of cervical lordosis. Material/Methods: Thirty patients with loss of cervical lordosis and 30 controls matched for age, sex, and body mass index were included in the study. Sixty vertebral arteries in patients with loss of cervical lordosis and 60 in controls without loss of cervical lordosis were evaluated by Doppler ultrasonography. Vertebral artery hemodynamics, including lumen diameter, flow volume, peak systolic velocity, end-diastolic velocity, and resistive index, were measured, and determined values were statistically compared between the patient and the control groups. Results: The means of diameter (p=0.003), flow volume (p=0.002), and peak systolic velocity (p=0.014) in patients were significantly lower as compared to controls. However, there was no significant difference between the 2 groups in terms of the end-diastolic velocity (p=0.276) and resistive index (p=0.536) parameters. Conclusions: The present study revealed a significant association between loss of cervical lordosis and decreased vertebral artery hemodynamics, including diameter, flow volume, and peak systolic velocity. Further studies are required to confirm these findings and to investigate their possible clinical implications.
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    The effects of caffeic acid phenethyl ester on inflammatory cytokines after acute spinal cord injury
    (Turkish Assoc Trauma Emergency Surgery, 2015) Ak, Hakan; Gulsen, Ismail; Karaaslan, Tamer; Alaca, Ilker; Candan, Aydin; Kocak, Havva; Atalay, Tugay
    BACKGROUND: The purpose of this study was to investigate the effects of Caffeic Acid Phenethyl Ester (CAPE) on proinflammatory cytokines, IL-1 beta and TNF-alpha, and explore its healing effect after acute spinal cord injury. METHODS: Forty-eight male Wistar-Albino rats were used in this study which was planned as three groups. All groups were divided into two sub-groups. Group la was the control group, in which only lower segment thoracic laminectomy was performed. In group lb, spinal cord trauma was performed with aneurysm clip. In the second group, serum physiologic was given systemically thirty minutes after trauma, and rats were sacrificed after the first and sixth hour. In the third group, CAPE was given systemically thirty minutes after trauma, and rats were sacrificed after the first and sixth hour. Serum IL-1 beta and TNF-alpha levels were analyzed by ELISA in the serum. Histopathological analysis was performed in damaged cord tissues. RESULTS: CAPE suppressed TNF-alpha and IL-1 beta levels in the serum. In histopathological evaluation, it was detected that CAPE decreased hemorrhage and necrosis. CONCLUSION: CAPE suppresses the levels of proinflammatory cytokines, TNF-alpha and IL-1 beta, after acute spinal cord injury in the early phase and contributes to the healing process.
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    Recurrent Gliosarcoma in Pregnancy
    (Hindawi Ltd, 2014) Gulsen, Ismail; Ak, Hakan; Yilmaz, Tevfik; Bulut, Mehmet Deniz; Alkis, Ismet; Bayram, Irfan
    Gliosarcoma is a rare tumor of the central nervous system and it constitutes about 1 to 8% of all malignant gliomas. In this report we are presenting a recurrent gliosarcoma case during a pregnancy in a 30-year-old woman. This is the first report presenting gliosarcoma in the pregnancy.
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    The relationship between facet joint osteoarthritis and Modic changes of the lumbar spine: a retrospective magnetic resonance imaging study
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2016) Alpayci, Mahmut; Bulut, Mehmet Deniz; Yazmalar, Levent; Yavuz, Alpaslan; Toprak, Murat; Koparan, Ibrahim Halil; Gulsen, Ismail
    Objectives: This study aims to assess the facet joint osteoarthritis in patients with lumbar Modic changes and to investigate the relationship between the Modic types and severity of the facet joint degeneration. Patients and methods: A total of 120 patients (55 males, 65 females; mean age 55.18 +/- 9.47 years; range 40 to 75 years) were included in the study. The patients were divided into four equal groups of 30 patients according to Modic type (No Modic changes, type 1, type 2, type 3). All groups were matched with age, sex, and spinal level. A total of 180 lumbar facet joints of the patients with Modic changes (60 facet joints for each Modic type) and 60 lumbar facet joints of the patients without Modic changes were analyzed. The severity of the facet joint osteoarthritis was assessed. The degree of the facet degeneration was evaluated by using the Pathria grading system with magnetic resonance imaging. Results: Facet joint degeneration increased gradually, as the type of Modic change increased. Compared to the group without Modic changes, all three groups with Modic changes had more degenerative facet joints (all p <= 0.002). The severity of the facet joint degeneration was significantly higher in type 3 versus type 1 Modic changes (p=0.022). Conclusion: Our study results suggest that Modic changes, particularly type 3, are strongly associated with the facet joint osteoarthritis of the lumbar spine. Clinically, facet joint degeneration should be considered in the examination of low back pain inpatients with Modic changes.