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Öğe Abdominal vascular injury during lumbar disc surgery: report of three cases(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2007) Torun, Fuat; Tuna, Hakan; Deda, HalukAnterior longitudinal ligament perforation and abdominal vascular injury is one of the most critical complications that may develop during lumbar disc surgery. The vascular injury-related symptoms that warns the surgeon may be late to appear; they usually turn out to be mortal. The hypotension during the operation, tachycardia and pulsatile unstoppable hemorrhage observed in the disc space are the major findings. Urgent detection of this complication and the repair of the vascular injury prevent the case from turning out to be fatal. In the present study, three patients who underwent surgical treatment of abdominal vascular injuries that had developed during lumbar disc surgery, were presented.Öğe Ağrılı lomber vertebra çökme kırığı ve lumbosakral spondilolistezisi olan bir vakada tedavi(2006) Torun, Fuat; Kalkan, Erdal; Çiçek, Onur; Erdi, FatihAmaç: Bu yazıda aynı seansta balon kifoplasti ve lumbosakral stabilizasyon işlemi yapılan hastanın kliniği ve uygulanan cerrahi prosedür tartışılmıştır. Olgu sunumu: Yirmi dört yaşında erkek hasta, kliniğimize sırt, bel ve her iki bacakta ağrı, uyuşukluk yakınması ile başvurdu. Klinik ve radyolojik incelemelerinde, L1 lomber vertebra çökme kırığı ve instabil lumbosakral listezis saptandı. Hastaya aynı seansta L1 balon kifoplasti, L5-S1 transpediküler vida-rod sistemi ile stabilizasyon ve internal fiksasyon uygulandı. Sonuç: Balon kifoplasti ve lumbasakral stabilizasyon işleminin aynı seansta uygulanması göreceli olarak postoperatif dönemde gelişebilecek komplikasyonların değerlendirilmesinde zorluk yaratabilir. Ancak cerrahi deneyim ve uygun endikasyon ile gelişebilecek komplikasyonlar minimalize edilebilir.Öğe Bilateral Traumatic Neuroma of the Anterior Cervical Nerve Root(2005) Torun, Fuat; Tuna, Hakan; Kahiloğulları, Gökmen; Bağdatoğlu, Celal; Çağlar, ŞükrüObjectives. A rare case of anterior cervical second root traumatic neuroma with no history of trauma is reported, and possible etiology is discussed. Summary of Background Data. Traumatic neuroma is the reactive, nonneoplastic proliferation in the injured nerve. Several atypical locations of traumatic neuroma have been reported. To date, only 4 cervical traumatic neuroma cases with no history of trauma have been reported, and, to our knowledge, there is no case of bilateral cervical traumatic neuroma published in the literature. Methods. A patient with a history of neck and left upper extremity pain, who had hypoesthesia in left C2 dermatome on neurologic examination is presented. A left C2–C3 hemilaminectomy and tumor extirpation were performed. Results. A histopathologic study revealed features of a typical traumatic neuroma. The patient had no deficits on her postoperative neurologic examination, and her neck and left arm pain improved. The unusual location of this lesion and possible etiology of such a traumatic neuroma are discussed. Conclusions. A rare case of anterior bilateral cervical second root traumatic neuroma with no history of trauma is reported. An unnoticed history of trauma may play an etiologic role in the development of these lesions.Öğe Çift kompartman hidrosefaliye neden olan Dandy Walker Sendromu(2005) Cengiz, Şahika Liva; Torun, Fuat; Güzeş, Atılgan EylemAmaç: Bu yazıda dual şant yerleştirilerek başarı ile tedavi edilen çift kompartman hidrosefaliye neden olan Dandy Walker Sendromu (DWS) olgusu sunuldu ve bu konu ile ilgili literatür gözden geçirildi. Olgu sunumu: Bilateral katarakt, hipotoni ve sık infantil spazm bulunan 8 aylık bir olguda DWS tespit edildi. Aquaduktus stenozuna bağlı çift kompartman hidrosefali görülmesi üzerine olguya dual şant uygulandı. Operasyon sonrası hastanın nörolojik muayenesinde hızlı düzelme tespit edildi. Sonuç: DWS’ye eşlik eden çift kompartman hidrosefali nadir görülür. Cerrahi tedavi planlanan çift kompartman hidrosefalilerde dual şant uygulanması gereklidir.Öğe Co-occurence of Auto-Immune Thyroid Disease and Acromegaly(2006) Torun, Nur Ayşe; Kulaksızoğlu, Mustafa; Torun, Fuat; Güvener, NilgünAmaç: Yazıda akromegali tanısı alan ve aynı zamanda oto-immün tiroid hastalığı eşlik eden iki vaka sunulmuş olup, akromegali ile oto-immün tiroid hastalığı birlikteliği tartışılmıştır. Yöntem: Vaka sunumu Sonuç: Akromegali ve tiroid hastalığı birlikteliği sık görülen bir durum olmasına karşın, akromegali ile oto-immün tiroid hastalığının birlikteliği nadirdir. Akromegalik hastalar değerlendirilirken mevcut semptomların, birliktelik gösteren bir tiroid hastalığına da ait olabileceği, nadir bir birliktelikte olsa oto-immün tiroid hastalığının var olabileceği akılda tutulmalı ve semptomlar akromegaliye bağlanmadan önce bu durum da göz önünde bulundurulmalıdır.Öğe Effect of iloprost on adrenal medullary grafts in central nervous system transplantation and apoptosis(RIYADH ARMED FORCES HOSPITAL, 2007) Caglar, Sukru; Torun, Fuat; Erdemli, Esra; Torun, Ayse N.Objective: To investigate whether iloprost, a stable analog of prostacyclin, is useful for the preservation of neural grafts in transplantation surgery. Methods: This study was conducted at the Microsurgery Laboratory of the Department of Neurosurgery, Faculty of Medicine, Ankara University, Ankara, Turkey in 2003. The animals (rabbits) were divided into 3 groups. In group I, autografts taken from the adrenal medulla were stored in 0.9% sodium chloride (NaCl) solution for 45 minutes before transplantation. In group II, autografts taken from the adrenal medulla were stored in iloprost solution (50 ng/ ml) for 45 minutes before transplantation. Graft transplantation was not performed in the third group. Results: In group 1, the grafts partially preserved their viability. In group II, the large adrenal medullary cells had evident euchromatin nuclei fused with neurons, and there was an increase in vascularization. Conclusions: Three weeks after transplantation surgery, it was determined that iloprost maintained the viability of the graft tissue and probably prevented apoptosis, and facilitated the integration of the graft tissue into the host brain.Öğe The effect of meperidine-impregnated autogenous free fat grafts on postoperative pain management in lumbar disc surgery(LIPPINCOTT WILLIAMS & WILKINS, 2008) Kalkan, Erdal; Torun, Fuat; Tavlan, Aybars; Cengiz, Sahika Liva; Kaya, BuelentStudy Design: Prospective, randomized, double-blind clinical study. Objective: To examine the effect of meperidine-impregnated autogenous free fat grafts (AFFGs) on postoperative pain management after 1-level, first-time lumbar disc surgery. Summary of Background Data: Uncontrolled postoperative pain impedes patient recovery. Insuffidient control of postoperative pain makes it difficult to convince new patients to undergo the lumbar disc surgery. Methods: Twenty-seven patients scheduled to undergo lumbar microdiscectomy for the first time were divided into 2 groups by a randomized double-blind method. Group 1 patients received a meperidine-impregnated AFFG in the epidural area. Group 2 received the graft without meperidine impregnation. Both groups were asked to use a Patient Controlled Analgesia device to deliver tramadol, and at 1, 4, 12, and 24 hours postoperatively, the amounts of tramadol used and pain severity on the 10-cm Visual Analog Scale (VAS) were recorded. Results: The VAS scores and total tramadol use were both lower in group 1 compared with the control group (P < 0.05). The first hour of VAS scores were significantly lower in group 1 than in the control group (P < 0.05). Conclusions: In this study, we helped patients, who underwent I-level, first-time lumbar microdiscectomy have a postoperative pain-free and comfortable period by using epidural meperidine-impregnated AFFGs.Öğe The lumbar roots and pedicles: a morphometric analysis and anatomical features(ELSEVIER SCI LTD, 2008) Torun, Fuat; Tuna, Hakan; Buyukmumcu, Mustafa; Caglar, Sukru; Baysefer, AlperThe objective of this study was to conduct a morphometric analysis of the lumbar nerve roots and surrounding structures. In this investigation, the lumbar roots were studied in 14 cadavers (70 lumbar vertebrae). Lumbar pedicle heights and widths were measured at every level of the lumbar vertebrae. The largest mean root diameter was 5.6 mm (L5 root) and the smallest 3.5 mm (L1 root). With regard to the root-dura exit angle, the widest was measured at L1 as 26.2 +/- 1.6 degrees and the narrowest at L5 as 16.3 +/- 2.4 degrees. The widest lumbar pedicle was measured at L5 as 17.1 +/- 4.2 mm and the narrowest at L1 as 8.4 +/- 1.8 mm. The longest lumbar pedicle was measured at L2 as 15.3 +/- 2.2 mm and the shortest at L4 as 13.8 +/- 2.3 mm. Quantitative measurements of lumbar root diameters, their exit angles from the dura, and lumbar pedicle heights and widths in anatomical dissection models may help us to gain a deeper understanding of the pathologies of this region and positively influence the success of surgical interventions. (c) 2007 Elsevier Ltd. All rights reserved.Öğe Morphometric analysis of the roots and neural foramina of the lumbar vertebrae(ELSEVIER SCIENCE INC, 2006) Torun, Fuat; DoIgun, Habibullah; Tuna, Hakan; Attar, Ayhan; Uz, Aylin; Erdem, AtillaBackground: There have been few anatomic studies on the foramina and roots of the lumbar region, and those available in human specimens are usually based on computed tomography and magnetic resonance imaging methods. Methods: Using the recent breakthroughs in microscopic anatomic dissections, the roots and vertebral foramina of the lumbar region were examined in 15 cadavers. Morphometric analysis of the roots and vertebral foramina of 80 lumbar vertebral objects was conducted. Results: The transverse and sagittal diameters of the lumbar intervertebral foramina were measured at each vertebral level. The median diameter of the lumbar neural foramina was 8.8 +/- 1.7 mm for the transverse and 19.4 +/- 2.7 mm for the sagittal planes. The widest median diameter of roots was 3.9 mm in the L4 root, and the narrowest was 3.3 mm in the L1 root. Conclusion: Quantitative measurements of the diameters of the neural foramina and roots of the lumbar region in anatomic dissection models may provide a deeper understanding about the pathologies of this region and influence the success of surgical interventions. (c) 2006 Elsevier Inc. All rights reserved.Öğe Primary lumbar vertebral hydatid cyst(CHURCHILL LIVINGSTONE, 2008) Kalkan, Erdal; Torun, Fuat; Erdi, Fatih; Baysefer, AlperSpinal hydatid cyst is a serious and rare infectious disease. We report a case of spinal hydatid cyst at the second lumbar vertebra, and we discuss the clinical presentation, diagnosis and surgical treatment of vertebral hydatid cyst. (C) 2007 Elsevier Ltd. All rights reserved.Öğe Spontaneous Regression of an Extruded Lumbar Disc Herniation: A Case Report(2007) Torun, FuatL5-S1 seviyesinde spontan gerileme gösteren ekstrude lomber disk herniasyonu vaka olarak sunulmuştur. Gerileme gösteren disk herniasyonu, manyetik rezonans görüntüleme yöntemleriyle gösterilmiştir. Bu sürecin altında yatan muhtemel mekanizmalar tartışılmıştır.Öğe Thoracic Epidural Cavernous Haemangioma: A Case Report(2006) Torun, Fuat; Kalkan, Erdal; İlik, Kemal; Erdi, Fatih; Baysefer, AlperKavernöz hemangiomalar, craniospinal sinir sisteminin nadir görülen benin vasküler malformasyonlarıdır. Epidural spinal kavernöz hemangiomalar, intraserebral ve vertebral sistemin diger lokalize kavernöz hemangiomalarından daha nadir görülür. Bu yazımızda spinal kavernöz hemangiomaların klinik görüntüsü ve ayırıcı tanısı tartışılmıştır.
