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Öğe Comparison of anterior cervical discectomy fusion techniques: Bladed and non bladed PEEK cages(Turkish Neurosurgical Soc, 2016) Güven, Mustafa; Çoşar, Murat; Alkan, Bahadır; Aras, Adem Bozkurt; Akman, Tarık; Şafak, Özbey; Karaarslan, Öznur; Ceylan, Davut; Tokmak, MehmetAIM: The aim of this study is to compare the different types of fusion materials known as PEEK cages used during anterior cervical discectomy (ACD) surgery. MATERIAL and METHODS: A total of 67 patients were operated and evaluated retrospectively under two groups (group A: 35 PEEK cage patients, group B: 32 bladed PEEK cage patients) between 2009 and 2013. Preoperative and postoperative (postoperative first day, postoperative 1st, 3rd and 12-24th mo) images were obtained. The cervical disc heights, cervical and segmental lordotic angles of the operated levels were calculated. Pain assessment was performed and fusion rates were also compared. Mann-Whitney U test was applied to compare the outcomes. RESULTS: The pain scores (especially for arm pain) were decreased significantly in both groups after surgery regardless of the type of operation technique (P<0.05). There were no significant differences between both groups at the disc height measurements of operated levels in postoperative periods (P>0.05). In addition to these; there was no significant difference between both groups of segmental and cervical lordodic angles in postoperative periods (P>0.05). There was no statistically significant difference between the fusion rates and pain scores of both groups (P>0.05). CONCLUSION: The PEEK cage and bladed PEEK cages can be used safely to obtain fusion after ACD.Öğe Determining the morphometry and variations of the confluens sinuum and related structures via a silicone painting technique on autopsy patients(Lippincott Williams & Wilkins, 2014) Coşar, Murat; Şeker, Aşkın; Ceylan, Davut; Tatarlı, Necati; Şahin, Fevzi; Tokmak, Mehmet; Songur, Ahmet; Kılıç, Türker; Özen, Oğuz AslanIn this study, we aimed to investigate the morphometric and morphologic structures of the confluens sinuum (CS) and related structures with a silicone painting technique. We studied 30 cadavers. Twelve of them were washed with alcohol and filled with a silicone painting technique via the vena jugularis interna, internal carotid artery, and vertebral artery. The other 18 were autopsied postmortem. The CS and related structures were dissected under microscope. Their anatomy was investigated, and variations were noted. The diameters of the sinus sagittalis superior (SSS), CS, occipital sinus (OS), sinus rectus (SR), and bilateral transverse sinus (TS), and the angle between SSS and SR were measured. The mean diameters were 11.7 mm for SSS, 22.3 mm for CS, 5.25 mm for OS, 7.5 mm for SR, and 9.7 (right) and 9.1 mm (left) for TS. The angle between the SR and SSS was 58 degrees. There was no difference in the bilateral venous structures that drained to the SSS and TS. There was an extra drainage to the CS from the left side in 4 cases. The right TS was located superiorly in 7 cases compared with the left TS, and this process was correlated with the type of CS. A septum in the SSS was detected in 2 cases. In addition, we encountered an OS in 80% of the cases. We conclude that the septum inside the CS affects the dominancy of the TS, the angle between the SSS and SR, and the other venous variations.Öğe Effect of using high-speed drill in anterior cervical discectomy and fusion(Turkish Neurosurgical Soc, 2016) Güven, Mustafa; Ceylan, Davut; Aras, Adem Bozkurt; Akbal, Ayla; Gökmen, Ferhat; Reşorlu, Hatice; Alkan, Bahadır; Tokmak, Mehmet; Coşar, MuratAIM: The objective of this study was to investigate the effect of using 2 different surgical techniques (curette or high-speed drill) in anterior cervical discectomy surgery on the healing of cases. MATERIAL and METHODS: Fifty-four operated cervical disc hernia cases were retrospectively examined in 2 groups. Discectomy and osteophytectomy were carried out in Group A by using a high-speed drill, while a curette was used for group B. Preoperative and postoperative computerized tomography and direct radiography were performed. Cervical disc height, cervical and segmental lordotic angles were calculated. The visual analogue scale and Odom's criteria were used in the assessment of pain and clinical healing. The fusion ratio of both groups was compared. The Mann-Whitney U test was used to compare data from the groups. RESULTS: Satisfactory results were obtained in the groups where high-speed drill and curette were used. Independently from the surgical technique, pain scores were significantly reduced in both groups after surgery. No radiologically significant differences were identified between the two groups within the postoperative period. CONCLUSION: Either high-speed drill or curette can be chosen for the osteophytectomy and discectomy stages of anterior cervical discectomy operations.Öğe Falcine venous plexus within the falx cerebri: Anatomical and scanning electron microscopic findings and clinical significance(2013) Tatarlı, Necati; Ceylan, Davut; Canaz, Hüseyin; Tokmak, Mehmet; Bay Hacıoğlu, Hüsniye; Şeker, Aşkın; Keleş, Evren; Kılıç, Türker; Çavdar, SafiyeBackground: Only limited attention has been paid to the anatomy and clinical importance of the falcine venous plexus. The aim of this study was to evaluate the falcine venous plexus anatomically using scanning electron microscopy (SEM), and to provide guidance for neurosurgical approaches. Methods: Latex or ink was injected into the superior and inferior sagittal sinus. The falcine venous plexus lying within the connective tissue of the falx cerebri was observed by dividing the falx into thirds (anterior, middle and posterior). Further, the SEM appearance of the falcine venous plexus was evaluated. Results: The anterior third of the falx cerebri consisted of small diameter falcine venous vessels. These vessels were localized close to either the superior or inferior sagittal sinus, and none extended as far as mid-falx cerebri levels in any of the 16 cases. They communicated with either superior or inferior sagittal sinuses, but not with both of these sinuses. In the middle third of the falx cerebri, the majority of the vessels of the falcine venous plexus had larger diameter compared to those of the anterior third. These vessels extended the length of the falx cerebri levels. They communicated with both superior and inferior sagittal sinuses. In the posterior third of the falx cerebri, the vessels of the falcine venous plexuses had the largest diameter and were located at the junction of the inferior sagittal sinus and the straight sinus. They were localized at the lower two-thirds of the falx cerebri. In all cases, the dense venous networks communicated with the inferior sagittal sinus but not with the superior sagittal sinus. The falcine venous plexus observed in the posterior third of the falx cerebri was denser than in the anterior and middle portions. The SEM revealed small vessels whose diameter ranged between 42 and 138 µm. The vessels of the falcine venous plexus in the anterior third had a mean diameter of 0.42 ± 0.1 mm, in the middle third a mean diameter of 0.87 ± 0.17 mm, and in the posterior third, 1.38 ± 0.21 mm. Conclusion: The falcine venous plexus is a network of venous channels that exists within the connective tissue of the falx; the sizes and patterns of communication of these structures showed regional differences. Neurosurgeons should be aware of the regional differences when making an incision or puncturing the falx during a surgical approach.Öğe Management of type II odontoid fractures for osteoporotic bone structure: Preliminary report(Turkish Neurosurgical Society, 2015) Coşar, Murat; Özer, Ali Fahir; Alkan, Bahadır; Güven, Mustafa; Akman, Tarık; Aras, Adem Bozkurt; Ceylan, Davut; Tokmak, MehmetAIM: Anterior transodontoid screw fixation technique is generally chosen for the management of type II odontoid fractures. The nonunion of type II odontoid fractures is still a major problem especially in elderly and osteoporotic patients. Eleven osteoporotic type II odontoid fracured patients were presented in this article. MATERIAL and METHODS: We have divided 11 patients in two groups as classical and Ozer's technique.We have also compared (radiologically and clinically) the classical anterior transodontoid screw fixation (group II: 6 cases) and Ozer's transodontoid screw fixation technique (group I: 5 cases) retrospectively. RESULTS: There was no difference regaring the clinical features of the groups. However, the radiological results showed 100% fusion for Ozer's screw fixation technique and 83% fusion for the classical screw fixation technique. CONCLUSION; In conclusion, we suggest that Ozer's technique may help to increase the fusion capacity for osteoporotic type II odontoid fractures.
