Browsing by Author "Onal, Mehmet Bulent"

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The Effect of Using a Dose of Prophylactic Antibiotics on Spondylodiscitis in Lumbar Disc Surgery
(2020) Diren, Furkan; Onal, Mehmet Bulent; Can, Halil; Kircelli, Atilla
Objective: Although spondylodiscitis seen after lumbar discectomy is very rare, its incidence has been reported to be around 0.1-18.8% by many different authors. The most common pathogen is Staphylococcus aureus. Methods: Medical records of 1,154 patients who were operated in our hospital between 2007 and 2015 due to a single or two-level lumbar disc hernia were retrospectively extracted. Of these patients, 554 were female and 600 were male. Discectomy operation was performed in 1,062 of these patients with single-level and 91 with two-level lumbar microdiscectomy. All of these patients were given a prophylactic single dose of cefazolin sodium in accordance with the recommendations of the surgical antimicrobial prophylaxis guidelines during anesthesia. Spondylodiscitis developed in 12 patients (1.03%). Comorbidities in patients who developed spondylodiscitis, isolated pathogens, antibiotic susceptibility, antibiotics used, and hospital stay were noted. Results: Of the 12 patients, 7 were female and 5 were male. Mean age was 45.75 +/- 14.16 years. Eleven of these patients underwent single level, one had 2 levels of lumbar microdiscectomy. Five patients underwent discectomy at L4-5 and 8 patients at L5-S1 levels. Three of these patients had S. aureus (25%), 4 had Staphylococcus epidermidis (33%) and 3 had Escherichia coli (25%) and 2 patients had no reproduction. The mean hospital stay was 29.45 +/- 3.98, and in patients without spondylodiscitois it was 1.99 +/- 0.81, the two groups were significantly different from each other (p=0.0001). Conclusion: Although most surgeons nave a tendency to maintain antibiotic prophylaxis postoperatively or during hospitalization period, our study found that a single dose prophylactic antibiotic administered during anesthesia induction did not increase rate of spondylodiscitis by medical literature.
Lumbosacral Conjoined Root Anomaly: Anatomical Considerations of Exiting Angles and Root Thickness
(2017) Kircelli, Atilla; Can, Halil; Kavadar, Gulis; Civelek, Erdinc; Cansever, Tufan; Aydoseli, Aydin; Onal, Mehmet Bulent; Yilmaz, Cem; 0000-0003-2109-1274; 27593795
AIM: Conjoined nerve roots (CNR) can be damaged during lumbar disc surgery and lead to neuropathic pain due to excessive retraction. The purpose of this study was to investigate the factors that facilitate the identification of CNRs that can lead to the loss of fragments in the secondary axilla, nerve root injury or unpleasant surprises during lumbar disc surgery. Accordingly, we aimed to measure the thicknesses and exit angles of the nerve roots close to the pedicle to obtain scientific data regarding rare double roots. MATERIAL and METHODS: The data of 612 patients who were operated for lumbar disc disease in our hospital between 2012 and 2014 were reviewed retrospectively. Twenty one cases of CNR were detected in this series. RESULTS: The mean nerve root thickness was 1.92 0.45 mm for medially located roots and 3.33 +/- 0.95 mm for laterally located roots. The comparison of medially located roots versus laterally located roots revealed a significant difference in mean values (p<0.0001). The mean exit angle was 12.29 degrees +/- 4.89 degrees for medially located roots, and 22.11 degrees +/- 5.42 degrees for laterally located roots (p<0.0001). In addition, the exit angles of the medially and laterally located roots increased as going down to caudal levels, (p=0.005, p=0.042). CONCLUSION: CNRs are congenital anomalies that are usually diagnosed during the surgical procedure and affect the success of discectomy. The presence of a more medially located or thinner root during surgical exploration and the absence of the fragment in the axilla in extruded or sequestered discs usually indicate a conjoined nerve root closer to the pedicle.