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Öğe Efficacy of Gabapentin for Radiculopathy Caused by Lumbar Spinal Stenosis and Lumbar Disk Hernia(Japan Neurosurgical Soc, 2010) Kasımcan, Ömür; Kaptan, HülagüThe efficacy of gabapentin monotherapy was investigated against both acute or chronic radicular pain caused by lumbar disk hernia (LDH) or lumbar spinal stenosis (LSS). Seventy-eight patients with radicular pain, 10 males and 68 females aged 23 to 76 years (mean 49.4 years), caused by LSS in 45 patients or LDH in 33 patients were treated with oral administration of gabapentin and were followed up for 3 months. The evaluation included neurological examination, Odom's criteria, visual analog pain scale (VAS), and walking distance. Gabapentin treatment resulted in decreased VAS scores in both groups. Odom's criteria scores had improved to excellent or good in 36 patients with LSS and 28 patients with LDH. Furthermore, walking distance was significantly longer at the 3rd month of the treatment protocol. Eight patients discontinued gabapentin therapy because of the side effects. Gabapentin could be an option in the conservative management of acute or chronic radicular pain.Öğe Protective effects of methotrexate and tenoxicam in peridural fibrosis in rat laminectomy model(Ege University Press, 2015) Kasımcan, Mustafa Ömür; Kaptan, Hülagü; Aktaş, Savaş; Bakar, Bülent; Karabağlı, HakanObjective: Peridural fibrosis after laminectomy is an important surgical problem. Tenoxicam is a nonsteroidal antiinflammatory drug and an oxicam derivative acting by inhibiting the formation of prostaglandin and eicosanoids. Low dose methotrexate which has been used as an antiinflammatory agent rhomatoid arthritis inhibits the synthesis of potentially toxic compounds those accumulate in inflamed tissues. The aim of this study was to evaluate and compare the efficacy of these two independent pharmacological agents in the inhibition of peridural fibrosis. Methods: L3-4-5 bilateral laminectomy with sparing the dura mater integrity was perfomed to 30 male Wistar albino rats. Except the SHAM group, low dose methotraxate (0.2 mg/kg) or tenoxicam (0.5 mg/kg) was administered on the dura mater before the surgical closure. After 42 days, all rats were euthanized and their spinal columns performed laminectomy were removed for the histopathological evaluation. Results: The peridural fibrosis grades of the groups administered low dose methotrexate or tenoxicam were lower than SHAM group grades. They have lower fibroblast counts than SHAM group numerically, although there was no statistically significant difference among groups. Conclusion: Local usage of low dose methotrexate and tenoxicam may be helpful option for prevention of peridural fibrosis after laminectomy procedures in future. © 2015, Ege University Press. All rights reserved.Öğe Protective Effects of Methotrexate and Tenoxicam in Peridural Fibrosis in Rat Laminectomy Model(2015) Kasımcan, Ömür; Kaptan, Hülagü; Aktaş, Savaş; Bakar, Bülent; Karabağlı, HakanAmaç: Laminektomi sonrası epidural fibrozis önemli bir cerrahi problemdir. Tenoksikam prostaglandin ve eikosanoidlerin oluşmasının azaltılmasında rol alan bir oksikam türevi ve steroid olmayan antienflamatuar bir ilaçtır. Düşük doz metotreksat potansiyel toksik bileşiklerin sentezini ve inflamasyon dokusunda bunların birikimini azaltan, yaygın kullanılan bir antimetabolit ajandır. Bu çalışmanın amacı epidural fibrozisin azaltılmasında iki bağımsız farmokolojik ajanın etkinliğinin karşılaştırılması ve değerlendirilmesidir. Yöntem: 30 erkek Wistar albino rat laminektomi modeli için kullanılmıştır. Dura bütünlüğü korunarak L3-4-5 laminektomi yapılmış, kontrol grubu haricindeki hayvanlara metotreksat (0,2mg/kg) ya da tenoksikam (0,5mg/kg) dura üzerine uygulanmış ve takiben cerrahi yara usulüne uygun şekilde kapatılmıştır. 42 gün sonra tüm hayvanlara ötenazi uygulanmış ve laminektomi yapılan spinal kolon parçası histopatolojik inceleme için tek parça halinde çıkarılmıştır. Sonuç: Epidural fibrozis düzeyi düşük doz metotreksat ve tenoksikam uygulanan gruplardaki hayvanlarda kontrol grubundakilerden düşük seviyede tespit edilmiş, ancak fibroblast sayıları bakımından gruplar arasında istatistiksel yönden belirgin fark saptanmamıştır. Yapılan bu çalışma sonunda laminektomi sonrası gelişebilecek epidural fibrozisin önlenmesinde düşük doz metotreksat ve tenoksikamın lokal kullanımının yararlı bir seçenek olabileceği kanısına varılmıştır.Öğe Protective Effects of Methotrexate and Tenoxicam in Peridural Fibrosis in Rat Laminectomy Model(JOURNAL NEUROLOGICAL SCIENCES, 2015) Kasımcan, Ömür; Kaptan, Hülagü; Aktaş, Savaş; Bakar, Bülent; Karabağlı, HakanObjective: Peridural fibrosis after laminectomy is an important surgical problem. Tenoxicam is a nonsteroidal antiinflammatory drug and an oxicam derivative acting by inhibiting the formation of prostaglandin and eicosanoids. Low dose methotrexate which has been used as an antiinflammatory agent rhomatoid arthritis inhibits the synthesis of potentially toxic compounds those accumulate in inflamed tissues. The aim of this study was to evaluate and compare the efficacy of these two independent pharmacological agents in the inhibition of peridural fibrosis. Methods: L3-4-5 bilateral laminectomy with sparing the dura mater integrity was perfomed to 30 male Wistar albino rats. Except the SHAM group, low dose methotraxate (0.2 mg/kg) or tenoxicam (0.5 mg/kg) was administered on the dura mater before the surgical closure. After 42 days, all rats were euthanized and their spinal columns performed laminectomy were removed for the histopathological evaluation. Results: The peridural fibrosis grades of the groups administered low dose methotrexate or tenoxicam were lower than SHAM group grades. They have lower fibroblast counts than SHAM group numerically, although there was no statistically significant difference among groups. Conclusion: Local usage of low dose methotrexate and tenoxicam may be helpful option for prevention of peridural fibrosis after laminectomy procedures in future.Öğe Servikal disk hernisinde PEEK cage’in erken dönem sonuçları(2009) Kasımcan, Ömür; Kaptan, Hülagü; Çakıroğlu, Kutay; Kılıç, CelalAmaç: Bu çalışmada servikal disk hernisinin cerrahi tedavisinde peek cage’in erken dönem sonuçları araştırılmıştır. Yöntem: Ocak 2001 ile Ekim 2005 tarihleri arasında kliniğimizde anterior yaklaşımla interbody cage füzyon uygulanan 85 olgu incelenmiştir. Anterior servikal mikrodiskektomi ve kafes (cage) füzyon yapılan hastalarımız postoperatif 1. gün, 3.ay ve/ veya 6. ay kontrolleriyle takip edildi. Tüm hastalarımız ameliyat öncesi ve sonrası nörolojik muayene ve radyolojik inceleme ile kontrol edildi. Bulgular: Olguların yaş dağılımı 29 ile 74 arasındadır (ortalaması 45.2’dir). En sık servikal disk hernisi tespit edilen mesafe 29 olgu ile C5-6’dır. Hiçbir olgumuzda peek cage’in yerinden dışarı çıkmasını tespit etmedik. Disk yüksekliğinde azalma görülmedi. Postoperatif dönemde izlenen hastalarımızın hiçbirinde servikal kifoz görülmedi. Sonuç: Peek cage erken dönemde intervertebral disk yüksekliğini korumuştur. Ancak klinik faydanın gösterilmesi için randomize çok merkezli ve uzun dönem takipli çalışmalar gereklidir.Öğe Social and occupational factors associated: Life time prevalence of low back pain in primary care(2010) İlhan, M. N.; Aksakal, Furkan N.; Kaptan, Hülagü; Ceyhan, M. N.; Durukan, Elif; İlhan, F.; Maral, I.Introduction: This study aims to determine the prevalence of life-time low back-pain and affecting occupational and social risk factors, in primary health care. Methods: A total of 2287 subjects (82,7%), aged 15 and over who has attended to five primary health care centers in the training and research district of Gazi University Department of Public Health in July- August 2005 and accepted to answer the questionnaire, participated in the study. Socio-demographic characteristics, working conditions, low back pain prevalence and some possible risk factors have been evaluated for the participants. Data has been processed by using SPSS 11.5 (Chicago, Il, USA) statistical programme. T-test was used for continuous variables and chi-square test for categorical variables. Results were presented with 95% Confidence Interval (CI) s, p values less than 0.05 was considered as statistically significant. Results: The mean age of the participants was 39.0±14.9 (15-86). %31.8 was male, %92.3 had social insurance, and 47.5% of them were housewives. The life-time low back pain prevalence was found to be 79.4%. LTBP risk was higher in person who was older, had higher BMI, experienced economic problems, was shorter and had lower educational level. And heavy-lifting, frequent bending up-rising and standing for long time was determined as occupational risk factors. LTBP risk was increased in workers and house-wives and decreased in person making sport for one hour a week. Conclusion: Life-time low back pain prevalence was considerably high among the study group. The determination of the risk factors and provision of necessary preventive approaches will decrease the prevalence of low back pain which is a prevalent health problem among community.
