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    Atlantoaxial rotatory subluxation in Eagle's syndrome: Is the styloid process protective?
    (Wolters Kluwer Medknow Publications, 2025) Secer, Mehmet; Yasin, Muge Elif; Ozcelik, Hakan
    A styloid process >3 cm is known as Eagle's syndrome (ES). This syndrome can lead to neurovascular symptoms. Traumatic atlantoaxial rotatory subluxation (AARS) is very rare in adults. We diagnosed AARS in a patient with ES after high-energy trauma. Posterior C1-2 stabilization was performed under traction. We wanted to discuss the mechanism of AARS in ES based on this case.
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    Efficacy of epidural steroid injections and evaluation of surgical and anesthetic approaches in far-lateral disc herniations
    (Future Medicine Ltd, 2023) Gurbuz, Hande; Secer, Mehmet; Gokbel, Aykut
    Aim: To observe the long-term effect of epidural steroid injections (ESI) and describe surgical outcomes in patients with far-lateral lumbar disc herniations. Materials & methods: The medical records of 30 patients who underwent surgery for far-lateral lumbar disc herniations were reviewed. Results: ESI outcomes: pain scores decreased significantly after ESI (p = 0.004). The surgery was delayed for 13.78 +/- 8.59 months in patients who received ESI. Surgical outcomes: the improvement in the leg pain was considerably more significant than the back pain (p < 0.001). While motor deficit improved substantially (p < 0.001), there was persistent sensory dysesthesia. Conclusion: ESI does not prevent but may delay the surgery up to 28 months. Although postoperative pain scores were significantly decreased, there was persistent back pain and sensory paresthesia. Plain language summaryFar-lateral lumbar disc herniation is a rare condition, and it constitutes a specific group of lumbar disc hernias regarding its anatomic location. It causes far more severe and intractable back and leg pain than the other widely known group of disc hernias. Sometimes, it can lead to sensation disorders and even functional impairment in the legs. Few can benefit from conservative treatments, including painkillers and physical therapy so surgical treatment becomes inevitable in many patients. Lumbar steroid injections to the epidural space may provide significant symptom relief and delay surgery in certain patients.
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    MAGNETİC RESONANCE IMAGİNG ANALYSİS OF THE FORAMEN AND DİSC SPACE İN PATİENTS WİTH L5 VERTEBRAL BODY HYPOPLASİA
    (Red Iris, 2023) Aksan, Ozgur; Secer, Mehmet; Ozdemir, Nail
    Objective: We studied those results of calculating foramen diameter and intervertebral disc height in normal patients and L5 hypoplasia. Design: This study is observational. Place & duration of study: Alanya Alaaddin Keykubat University, Department of Neurosurgery, Alanya, Turkey between January 2017 January 2020 Methodology: We performed with MRI of 20 patients with L5 hypoplasia and 20 control group. Anteroposterior diameter of L5, foraminal sizes, spondylolysis, spondylolisthesis, and intervertebral disc degeneration were assessed. Results: When L5 hypoplasia and control groups were evaluated, a statistically significant difference was observed when L4-5 and L5 - S1 AP diameters were compared. Both the right L5 and S1 foramen diameters and left L5 and S1 foramen diameters were significantly narrower in the patients with L5 hypoplasia compared with control group. Grade I true anterolisthesis was detected in 3 patients included in the L5 hypoplasia group. All patients with L5 hypoplasia had thinning of the pedicles and hypoplasia of the lower surfaces of the L5. Low-grade disc degeneration was observed in all patients at the L4- 5 and L5 -S1 levels of the L5 hypoplasia group. Conclusion: Physicians who detect vertebral body hypoplasia in radiological imaging studies such as MRI should definitely consider the possibility of spondylolisthesis, disc degeneration and foraminal stenosis that may develop in these patients. Even if such patients are asymptomatic, they should regularly follow up radiologically and clinically.
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    Salvage posterior atlantoaxial fixation techniques: A retrospective study
    (Elsevier Espana Slu, 2022) Secer, Mehmet; Karakoyun, Oguz Durmus; Ulutas, Murat; Gokbel, Aykut; Cinar, Kadir; Yigitkanli, Kazim
    Object: Since the atlantoaxial region have critical neurovascular anatomy and limited bone surface for fusion, the application and choice of salvage fixation techniques are highly important. To discuss alternative posterior atlantoaxial fixation surgery techniques. Methods: We retrospectively surgical records of 22 patients that posterior atlantoaxial fixation techniques were applied. Results: The patients included 11 males and 11 females (mean age: 65.7 years). The fracture type that caused instability is type 2 odontoid fractures (22). In six of these patients alternative stabilization techniques were applied due to anatomical variations, huge venous bleeding and iatrogenic trauma of the screw entry points during surgery. Conclusions: Owing to anatomical variations, intraoperative challenges, and/or instrumentation failures, performing alternative surgical fixation technique is an important factor that affects the success of stabilization of the atlantoaxial region. Knowledge of salvage techniques especially during the learning curve is vitally important. Surgeons should adapt to intraoperative surgical challenges as required. (c) 2021 Sociedad Espanola de Neurocirugia. Published by Elsevier Espana, S.L.U. All rights reserved.
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    Tract pain because of cervical spondylotic myelopathy: A case series
    (Elsevier Sci Ltd, 2021) Secer, Mehmet; Ulutas, Murat
    Spinal cord compression may lead to pain that is sometimes directed to areas far below the compression level. In certain cases, it may present as sciatica pain, knee pain or low back pain (LBP). These types of pain are called tract pain or funicular pain. Tract pain because of cervical spondylotic myelopathy (CSM) may lead to delays in the diagnosis and treatment of CSM in some cases, and sometimes unnecessary medical and surgical treatments. This study evaluated the results of four patients who presented to the outpatient clinic with complaints of LBP accompanying CSM findings. This study aims to present the improvement in low back pain as a result of anterior cervical microdiscectomy and cage procedure in four patients who presented with tract pain because of CSM, which is a rare condition. (c) 2021 Elsevier Ltd. All rights reserved.