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Item Bone Cement Leakage in Transpedicular Percutaneous Vertebroplasty: Analysis of 20 Patients(2018) Civi, Soner; Durdag, Emre; Suner, Halil Ibrahim; Kardes, Ozgur; Tufan, Kadir; 0000-0002-1055-5152; 0000-0003-2854-941X; 0000-0001-6939-5491; 0000-0002-5957-8611; 0000-0003-1509-4575; U-2400-2018; P-5895-2018; AAK-1734-2021; AAJ-5381-2021; AAK-1686-2021Objective: Percutaneous vertebroplasty (PVP) is one of the frequently preferred interventional methods in spinal surgery. Although it is classified as minimally invasive, the most common complication of this procedure is bone cement leakage. Leakage of bone cement is often asymptomatic, but can lead to serious complications such as paraplegia and pulmonary embolism. In this study, we aimed to investigate the complications and consequences of cement leakage in the percutaneous vertebroplasty procedure. Methods: Between 2009 and 2015, 20 (14 female and 6 male, mean age 69.7) patients who underwent percutaneous vertebroplasty to 26 vertebrae were included in the study. 17 vertebrae were treated for osteoporotic compression (65.3%), 4 vertebrae for pathologic compression fractures (15.3%), 4 vertebrae for traumatic compression fractures (15.3%) and 1 vertebrae for painful hemangioma (3.8%). Leakage localizations of bone cement were classified as venous plexus, paravertebral soft tissue, spinal canal, intervertebral foramen, into the niddle channel and intervertebral disc space. Results: Twelve vertebrae showed no leakage (46.1%). 5 vertebrae had leakage into the niddle channel (19.2%), and 3 had leakage to vertebra disc space leakage (11.5%) and 2 vertebrae had to venous plexus and paravertebral tissue leakage (7.6%) Foraminal and spinal canal leakage (3.8%) was observed in one patient on single level. Radicular pain was seen in one patient. Partial pain control was observed in 20% of the patients while 80% of the patients had complete pain control on follow ups. Conclusion: Major complications following percutaneous vertebroplasty are mostly due to bone cement leaks. In order to prevent major complications, it is necessary to determine the possible causes of leakage. Performing the application with the correct technique with properly prepared bone cement is essential. Also usage of contast dye may be useful for pre-injection risk of leakage complications.Item Magnetic Resonance Guided Stereotactic Biopsy of Intracranial Lesions: Analysis of 310 Cases(2018) Kardes, Ozgur; Durdag, Emre; Civi, Soner; Suner, Halil Ibrahim; Tufan, KadirObjective: Stereotaxic biopsy is an important surgical procedure that provides definite diagnosis in brain lesions. It is possible to obtain diagnosis with minimal invasive manner in deeply located and critical localized lesions. There are large case series in the literature. We aimed to present our experience of magnetic resonance (MR) guided 310 stereotaxic biopsies in this study. Method:We retrospectively evaluated age and gender distribution, locations of the lesions, histopathologic results, and complications of 310 cases which MR guided stereotactic biopsied was performed in our clinic between 2012 and 2018. In addition, technical information was also provided. Results:Stereotactic frame application was performed with local anesthesia and surgical procedure was performed by under general anesthesia. Of 310 patients 169 were male (55%) and were 141 female (45%). Mean age was 57.28 (3-87). 184 of the lesions were hemispheric (59%), and the most common diagnosis was glioblastoma multiforme (34.19%). 8 patients were not diagnosed (2%). Complications developed in 13 cases (4%) and 2 of cases were died in the early phase due to the procedure (0.6%). Histopathological diagnostic success was 99% Conclusion:The results of our study show that the stereotactic biopsy procedure applied in the MRI guideline is reliable and feasible with low complication rate and high effectiveness in cases where definitive histopathologic results are required for treatment planning.