PubMed İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Radiofrequency Thermocoagulation of the Ganglion Impar for Coccydynia Management: Long-Term Effects(2019) Kircelli, Atilla; Demircay, Emre; Ozel, Omer; Coven, Ilker; Isik, Semra; Civelek, Erdinc; Kabatas, Serdar; 0000-0003-2109-1274; 29617062Objective To investigate the short- and long-term effects of ganglion impar radiofrequency thermocoagulation (RFT) treatment in patients with chronic coccydynia. Methods We retrospectively analyzed the medical records of patients who underwent RFT of the ganglion impar between 2009 and 2011. Pain intensity visual numeric scale (VNS) scores and Euroqol 5D (EQ-5D) index scores were recorded pre-intervention and post-intervention at the first, sixth, and twelfth months. The differences between pre-procedural VNS scores and post-procedural VNS scores at the first, sixth, and twelfth months were evaluated. The success of the intervention was recorded as the percentage difference between the pre-intervention VNS scores and post-intervention VNS scores at the first, sixth, and twelfth months. Results The mean age of the patients, including 11 females (55%) and 8 males (45%), was 48.7 +/- 14.3 years. The average follow-up duration was 17.3 +/- 2.9 months. Statistically significant differences were observed between the pre- and post-procedure VNS scores (P < 0.0001). Improvements in VNS scores were correlated with improvements in EQ-5D index scores. Mid-term (sixth month) and long-term (twelfth month) evaluations after the intervention revealed that 67.4% and 61.1% of the patients had successful outcomes, respectively. Conclusion Our data suggested that RFT of the ganglion impar in patients with chronic coccydynia resulted in effective outcomes, and patients who responded to RFT had significantly lower post-RFT pain scores.Item Spinal Nerve Root Compositions of Musculocutaneous Nerve: An Anatomical Study(2014) Demircay, Emre; Musluman, Ahmet Murat; Cansever, Tufan; Yuce, Ismail; Civelek, Erdinc; Yilmaz, Adem; Kabatas, Serdar; Ozdes, Taskin; Sam, Bulent; 25448204AIM: This study was aimed to investigate the variations in the spinal nerve root compositions of musculocutaneous nerve and to confirm which spinal nerve root is the main ingredient in participating amount. MATERIAL and METHODS: A total of 20 fresh cadavers were dissected. Brachial plexus and its branches were extracted. Musculocutaneous nerve stump was traced back to the roots to identify its fascicular origin. The number of fascicles originating from a particular nerve root and their axial location with in the nerve were noted. RESULTS: The most frequent type of spinal nerve compositions of musculocutaneous nerve was C5, C6, and C7 with incidence of 60%. Musculocutaneous nerve had bundles from C5 root in all specimens, 90% of the specimens had contribution from C6 and only 70% of them had bundles from C7 root. There were a total of 46 (37.7%) bundles in C5 fascicles, 48 (39.3%) bundles in C6 fascicles, and 28 (22.9%) bundles in C7 fascicles. CONCLUSIONS: In electrophysiological studies it should be remembered that C7 or C6 lesions may not impair musculocutaneous nerve functions. The success of musculocutaneous nerve neurotization may be improved if care is taken to ensure whether or not C7 root is contributing to the musculocutaneous nerve.Item The Relationship of the Vertebral Artery with Anatomical Landmarks in the Posterior Craniovertebral Junction of Fresh Human Cadavers in the Turkish Population(2016) Akar, Aykan; Civelek, Erdinc; Cansever, Tufan; Aydemir, Fatih; Altinors, Mehmet Nur; 27161466AIM: Surgical anatomy concerning the posterior craniovertebral region in fresh human cadavers was studied to provide most accurate information for the surgical approach. MATERIAL and METHODS: In thirty-two fresh human cadavers, the distance from the posterior tubercle to the sulcus of vertebral artery (VA), the thickness and length of the third segment of VA (V3), the distance of C1/C2 facet to V3, the length, height and shape of the C2 ganglion to the neighboring structures, the distance from medial border of C1 lateral mass to dura mater, the distance of the transverse process of atlas to mastoid tip, the thickness of C1 posterior arcus were measured. RESULTS: There were variations of sulcus of VA in 14 of 32 cadavers (43.7%), the right VA was larger in 23 cadavers (71.8%). The ganglion was found over the C1 lateral mass screw entry point in 45 of 64 ganglions (70.31%) and below the screw entry point in 19 of 64 ganglions (29.69%). The distance of the medial border of the C1 lateral mass to dural tube was 3.81 +/- 0.55 mm at the right side and 3.91 +/- 0.59 mm at the left. The thickness of C1 posterior arch was 3.73 +/- 0.75 mm at the right side and 3.75 +/- 0.77 mm at the left. The mean distance from the transverse process of C1 to the mastoid tip was 15.82 +/- 4.49 mm at the right side and 15.46 +/- 4.38 mm at the left. CONCLUSION: This is the most comprehensive and only fresh cadaver study about this region in the literature.Item 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; 27593795AIM: 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.