Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Subject: search.filters.subject.Back pain

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    Role of the MyD88 Dependent Pathway in Degenerative Disc Disease
    (2023) Akgun, Mehmet Yigit; Akyol, Sibel; Ozlen, Fatma; Alizada, Orkhan; Cetintas, Semih Can; Turk, Okan; Hanci, Murat; 0000-0003-0942-9906; 37144651; E-1210-2019
    AIM: To define the substantial role of the TLR4 signaling pathway in the MyD88-dependent pathway, and to evaluate the results of TLR4 activation in nucleus pulposus cells. Moreover, we aim to associate this pathway with intervertebral disc degeneration and magnetic resonance imaging (MRI) findings. Additionally, the clinical differences among patients and the effects of their drug use will be evaluated. MATERIAL and METHODS: Eighty-eight adult male patients with lower back pain and sciatica underwent MRI studies, which showed degenerative changes. Disc materials were obtained intraoperatively from those who underwent surgery for lumbar disc herniation. These materials were kept in freezers at -80 degrees C without any delay. Then, the collected materials were examined using enzyme-linked immunosorbent assays. RESULTS: Modic type I degeneration had the highest values of all markers, whereas Modic type III degeneration had the lowest values. These results verified that this pathway plays an active role in MD. Moreover, contrary to the current knowledge on which Modic type inflammation is more dominant, we showed that it is the Modic type I phase. CONCLUSION: The most intense inflammatory process was observed in Modic type 1 degeneration, and the MyD88-dependent pathway was found to play a key role. While the most intense molecular increase was detected in Modic type 1 degeneration, the lowest levels were observed in Modic type III degeneration. It has been observed that the use of nonsteroidal anti-inflammatory drugs affects the inflammatory process through the MyD88 molecule.
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    The Global Spine Care Initiative: World Spine Care Executive Summary on Reducing Spine-Related Disability in Low- And Middle-Income Communities
    (2018) Sonmez, Erkin; https://orcid.org/0000-0002-5693-3542; 30151809; AAI-8820-2021
    Purpose Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI), which was convened to develop an evidence-based, practical, and sustainable, spinal healthcare model for communities around the world with various levels of resources. Methods Leading spine clinicians and scientists around the world were invited to participate. The interprofessional, international team consisted of 68 members from 24 countries, representing most disciplines that study or care for patients with spinal symptoms, including family physicians, spine surgeons, rheumatologists, chiropractors, physical therapists, epidemiologists, research methodologists, and other stakeholders. Results Literature reviews on the burden of spinal disorders and six categories of evidence-based interventions for spinal disorders (assessment, public health, psychosocial, noninvasive, invasive, and the management of osteoporosis) were completed. In addition, participants developed a stratification system for surgical intervention, a classification system for spinal disorders, an evidence-based care pathway, and lists of resources and recommendations to implement the GSCI model of care. Conclusion The GSCI proposes an evidence-based model that is consistent with recent calls for action to reduce the global burden of spinal disorders. The model requires testing to determine feasibility. If it proves to be implementable, this model holds great promise to reduce the tremendous global burden of spinal disorders.
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    Elastofibroma dorsi: A case report on an unobserved cause of back pain
    (2020) Guzel, Sukran; Ozen, Selin; Sozay, Seyhan; Kilic, Mehmet Dalokay; 0000-0002-8460-7699; 0000-0002-7290-8558; 0000-0001-9852-0917; 32962604; AAJ-2936-2021; ABC-1305-2020; AAG-3148-2021
    Elastofibroma dorsi (ED) is a rare, benign soft tissue tumor which often occurs in the subscapular region of elderly individuals and shows a female predominance. While many patients remain asymptomatic, ED can cause pain in the periscapular region. The clinical signs of ED are non-specific and variable which can result in misdiagnoses; it is often confused with rotator cuff and cervical spine pathologies. In this article, we present the case of a 78-year-old female patient with persistent back and shoulder pain. The patient was admitted to various clinics over a number of years for diagnostic investigations and treatment. However, the true etiology of back pain was never established and treatments were applied without any positive effect. Finally, when the patient presented to our clinic, a mass was detected in the right subcapular region. Thoracic computed tomography imaging was consistent with a diagnosis of ED. Due to the patient's persistent back pain, surgical excision of the tumor was performed. The pathology report confirmed the diagnosis. This case emphasizes the importance of a thorough examination in patients who may initially only have very subtle signs of the underlying pathology. This case also highlights the importance of re-visiting initial evaluations and differential diagnoses when faced with a difficult case of persistent back and shoulder pain so to avoid misdiagnoses and unnecessary treatments.