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    The effect of ethyl cyanoacrylate on experimental posterior lateral spinal fusion in a rat model
    (Via Medica, 2009) Gezici, Ali Riza; Ergun, Ruchan; Yilmaz, Fahri; Gurel, Kamil
    Background and purpose: Cyanoacrylates (CAs) are a type of tissue adhesives which are currently the most commonly used for cutaneous closings. The use of CAs was reported in other clinical procedures such as odontology, neurological surgery, maxillary surgery, orthopaedics, plastic surgery, etc. In this experimental study the authors carried out posterolateral spinal fusion in a rat model to test the usefulness of ethyl-cyanoacrylate (ECA) in fixation of allograft/autograft fusions. Material and methods: 25 Sprague-Dawley rats were randomized into two study groups. Bilateral posterolateral lumbar intertransverse process spinal fusion was performed with both autograft and allograft in both groups. ECA gel was dropped in the fusion area In a rat model in group II. Results: The fusion rates as determined by manual palpation were 75% in controls and 46% in the ECA group (p = 0.322). According to radiographic score, the spinal segment was considered to be fused radiographically in 66% of controls and in 46% of animals in the ECA group (p = 0.43). The mean histological scores were 5.58 +/- 0.14 and 4.53 +/- 0.18 for the control and treatment group, respectively (p = 0.001). The mean bone density of the fusion masses was 101.3 +/- 2.5 in the control group and 92.0 +/- 3.3 in the ECA treatment group (p = 0.044). Conclusion: Ethyl-cyanoacrylate appeared to retard the osteogenic fusion but was well tolerated and did not induce necrosis, allergic reaction, infection, necrosis or neurological deficit in a rat model of posterolateral spinal fusion.
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    Effects of minimally invasive decompression surgery on quality of life in older patients with spinal stenosis
    (Elsevier, 2015) Dağıstan, Yaşar; Dağıstan, Emine; Gezici, Ali Riza; Cancan, Seçkin Emre; Bilgi, Murat; Çakır, Uğur
    Objectives: Lumbar spinal stenosis (LSS) in the elderly may result in a progressive narrowing of the spinal canal leading to compression of nerve roots in some individuals. The aim of this study was to evaluate the quality of life changes after minimally invasive decompression surgery without instrumentation in geriatric patients with lumbar spinal stenosis. Patients and methods: This prospective clinical study included 37 patients with American Society of Anes-thesiologists (ASA) II-III scores between the ages of 65 and 86 years, who were planned to undergo surgical intervention due to LSS. All patients had neurogenic claudication and pain in the hips, thighs, and legs. Measurements of the osseous spinal canal were evaluated by magnetic resonance imaging. Before the surgical intervention, patient demographics and clinical characteristics were recorded. The Short-Form-36 test, the Oswestry Disability Index, and the Visual Analog Scale were applied to all patients preoperatively and two years postoperatively. Results: In the study population, 11 patients had single level of spinal stenosis, 20 patients had two levels of spinal stenosis, and six patients had three levels of spinal stenosis. There were significant differences between the preoperative and postoperative ODI and VAS scores. There was a statistically significant difference in all subscales of the SF-36 test with the exception of general health scores. Three patients who had dural damage during the operation were treated with bio glue. Also, no patients were recorded to have any neurological deficits and root injuries postoperatively. Conclusion: Minimally invasive decompression surgery, without instrumentation, for lumbar spinal stenosis in geriatric patients significantly improves the patients' quality of life. (C) 2015 Elsevier B.V. All rights reserved.
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    The therapeutic effects of cyclosporin-A on experimental spinal cord injury
    (Scientific Publishers of India, 2017) Gezici, Ali Riza; Kilic, Guven; Firat, Tulin; Cancan, Seckin Emre; Kukner, Aysel; Ozkan, Nezih; Dagistan, Yasar
    Background: According to the experiments, neutrophils and microglial cells are the first to attend the early phase of events in inflammatory response to SCI. Those pilot cells are seen in the first 12-24 hours and disappear about 3-5 days. The neutrophil accumulation and activation are steered by many cytokines such as TNF-?, IL-1 and IL-6. Neutrophils do accompany to the modulation of secondary injury mechanisms via neutrophil proteases and reactive oxygen molecules. When those processes are taken into account, depletion of neutrophils or depression of their functions may derive neuro-protection and neurological healing. Purpose: To investigate the therapeutic and neuroprotective effects of Cyclosporin-A (CSA) on recovery processes using clinical and histopathological tests, which has not been used very frequently in clip compression spinal cord injury (SCI) models. Material and methods: Twenty-four Spraque-Dawley rats were divided into three groups: group 1 [Sham-control, n=8], group 2 [SCI+2 mL saline intramuscular (i.m.), n=8], group 3 [SCI+5 mg/kg CSA (i.p.) 1 h after SCI and for the following three days, n=8]. Rats were evaluated 1st, 3rd, 5th and 10th days after SCI, clinically by Drummond and Moore scale and under light microscopy and by TUNEL test; after scarification on 10th day. Results: Clinical and histopathological results of treatment group were found significantly better than the results of the trauma group. Conclusion: CSA can depress apoptosis and necrosis rates in a statistically significant manner and carry out the statistical difference in clinical results. © 2017, Scientific Publishers of India. All rights reserved.
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    The therapeutic effects of etanercept-methotrexate combination on experimental spinal cord injury
    (Scientific Publishers of India, 2017) Gezici, Ali Riza; Akar, Semih; Firat, Tulin; Dagistan, Yasar; Cancan, Seckin Emre; Kukner, Aysel; Ozkan, Nezih
    Background: Experimental studies have demonstrated that neurons keep dying in an unrecoverable and non-regenerative pattern in following hours after primary mechanical injury to spinal cord. The cascade of events which is called secondary injury is composed of vascular impairment, oedema, ischemia, inflammation, exotoxicity, electrolyte imbalance, lipid peroxidation, free radicals, necrosis and apoptotic cell death. Aims: With clinical and histopathological tests, this study investigated the therapeutic effects of etanercept-methotrexate combination which is an option in mono-therapy resistant rheumatological diseases; but this combination has not been used on recovery processes in clip compression Spinal Cord Injury (SCI) model yet. Study design: Forty Spraque-Dawley rats were divided into five groups: group 1 (Sham-control), group 2 (SCI+2 ml saline intramuscular), group 3 (SCI+1.25 mg/kg etanercept), group 4 (SCI+0.5 mg/kg methotrexate) and group 5 (SCI+1.25 mg/kg etanercept+0.5 mg/kg methotrexate). Methods: Rats were evaluated 1st, 3rd, 5th and 10th days after SCI, clinically by Drummond and Moore scale, under light microscopy and by Tunel test; after sacrification on 10th day. Results: Clinical and histopathological results of all treatment groups were found significantly better than the results of the trauma group; also no superiority in the monotherapy groups, over each other, was noted. Conclusion: Combined-treatment group had a statistically significant better outcome in preventing apoptosis, but there was no difference according to the clinical results. © 2017, Scientific Publishers of India. All rights reserved.