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Item The Effect of Discharging Patients with Low Hemoglobin Levels on Hospital Readmission and Quality of Life after Adult Spinal Deformity Surgery(KOREAN SOC SPINE SURGERY, 2022-01-01) Nabi, Vugar; Ayhan, Selim; Yuksel, Selcen; Adhikari, Prashant; Vila-Casademunt, Alba; Pellise, Ferran; Perez-Grueso, Francisco Sanchez; Alanay, Ahmet; Obeid, Ibrahim; Kleinstueck, Frank; Acaroglu, Emre; Grp, European Spine StudyStudy design: Retrospective cohort. Purpose: This study aims to evaluate the impact of anemia on functional outcomes, health-related quality of life (HRQoL), and early hospital readmission (EHR) rates after adult spinal deformity (ASD) surgery at the time of discharge from the hospital. Overview of literature: Concerns with risks of transfusion, insufficient evidence for its benefits, and the possibility of associated adverse outcomes have led to restrictive transfusion practices. Therefore, patients are discharged according to patient blood management programs that are implemented in hospitals nationwide to reduce unnecessary blood transfusions. However, not many comprehensive kinds of studies exist on the effect of postoperative anemia on functional life and complications. Methods: Anemia severity was defined following the 2011 World Health Organization guidelines. All patients had HRQoL tests as well as complete blood counts pre- and postoperatively. EHR is the admission within 30 days of discharge and was used as the dependent parameter. Results: This study comprised 225 surgically treated ASD patients with a median age of 62.0 years, predominantly women (80\%). Of the 225 patients, 82, 137, and six had mild, moderate, and severe anemia at the time of discharge, respectively. Seventeen of the patients (mild {[}11, 64.7\%]Item Does the Application of Topical Intrawound Vancomycin Powder Affect Deep Surgical Site Infection and the Responsible Organisms after Spinal Surgery?: A Retrospective Case Series with a Historical Control Group(KOREAN SOC SPINE SURGERY, 2020-01-01) Adhikari, Prashant; Nabiyev, Vugar Nabi; Bahadir, Sinan; Ayhan, Selim; Yuksel, Selcen; Palaoglu, Selcuk; Acaroglu, EmreStudy Design: Retrospective case series with a historical control group. Purpose: To compare the deep wound infection rates in patients undergoing spinal surgery with the application of topical intrawound vancomycin powder (TIVP) in the surgical site in addition to standard systemic prophylaxis with those in a matched historical cohort of patients for whom TIVP was not used. Overview of Literature: Surgical site infection (SSI) after spine surgery is debilitating and is responsible for a significant increase in the health care costs, hospital stay, and morbidities. Although the application of TIVP before surgical closure is a promising method for reducing the SSI rate after spine surgery, its use is controversial, and currently, research trials are focusing on identifying its safety, efficacy, and the potential patient population. Methods: A group of 88 patients who underwent posterior spinal surgery with TIVP administration (treatment group) was compared to a historical control group of 70 patients who had received only standard systemic intravenous prophylaxis (control group) for the analysis of deep SSI rate and the involved organisms. Results: The overall rate of deep SSIs was 2.5\% (4/158). All the SSIs were observed in patients who had posterior instrumentation and fusion for >= 3 levels. In the treatment group, the SSI rate was 3.4\% (3/88), and the bacteria isolated were Escherichia coli (n=2 ) and Pseudomonas aeruginosa (n=1). In the control group, the infection rate was 1.4\% (1/70), and the isolated bacteria were Morganella rnorganii and Staphylococcus epidermidis. No statistically significant association was found between the SSI rates of the treatment and control groups. Conclusions: Although the difference in the SSI rates was not statistically significant, the present results suggest that TIVP administration could not reduce the risk of deep SSIs after spinal surgery. Moreover, TIVP administration might also affect the underlying pathogens by increasing the propensity for gram-negative species.Item The Past, Present, and Future Statuses of Formerly Classified ``Atypical Pituitary Adenomas'': A Clinicopathological Assessment of 101 Cases in a Cohort of More than 1,000 Pure Endoscopically Treated Patients in Single Center(THIEME MEDICAL PUBL INC, 2021-01-01) Bal, Ercan; Kulac, Ibrahim; Ayhan, Selim; Soylemezoglu, Figen; Berker, MustafaObjective This study was aimed to assess the clinical aggressiveness of pituitary neoplasms that were previously defined as atypical adenomas. Methods A total of 1,042 pituitary adenomas were included in the study and 101 of them were diagnosed as atypical adenoma. Demographic characteristics, radiological evaluations, and clinical information were obtained from a computer-based patient database. Cases were categorized as atypical or typical using the criteria listed in 2004 Classification of Tumors of Endocrine Organs. Results The cure and reoperation rates did not show any statistically significant difference between the typical and atypical adenomas. However, a higher K (i) -67 labeling index was found to be associated with a higher rate of reoperation ( p =0.008) in atypical adenomas. Of note, cavernous sinus invasion or parasellar extension was found to be associated with lower cure rates in patients with atypical pituitary adenomas ( p <0.001 and p =0.001, respectively). Conclusion Although atypical pituitary adenomas are known to be more invasive, this study demonstrated that the reoperation and cure rates are the same for typical and atypical adenomas. Our findings advocate for omitting the use of atypical adenoma terminology based solely on pathological evaluation. As stated in the 4th edition of the World Health Organization (WHO) classification, accurate tumor subtyping, evaluation of proliferation by means of mitotic count and K (i) -67 labeling index, and radiological and intraoperative assessments of tumor invasion should be taken into consideration in the management of such neoplasms.Item Stronger Together in Lab: Multi-Center and Laboratory Spine Studies Are Closer to Publication than Single-Center and Clinical Spine Studies: Snapshot of Annual Meetings of the Spine Society of Europe(KOREAN SOC SPINE SURGERY, 2020-01-01) Ozcan-Eksi, Emel Ece; Canbolat, Cagri; Ayhan, Selim; Eksi, Murat SakirStudy Design: This is a cross-sectional study of literature databases. Purpose: The purpose of this study is to analyze the predictive factors for the publication rates of spine studies. Overview of Literature: Spine research has garnered worldwide interest due to the increased number of spinal disorders in aging population. Methods: We evaluated the abstracts presented at the annual meetings of the Spine Society of Europe between 2009 and 2012. Additionally, we recorded presentation categories, study designs, research types, random assignments of the subjects, single- or multicenter-based methodologies, and significance of the results. Results: We evaluated 965 abstracts, 53.5\% of which were published in peer-reviewed journals. Publication rates were significantly higher for oral presentations (62.9\%) and prospective studies (61.3\%) as compared to the poster presentations (46.7\%) and retrospective studies (44.2\%), respectively ( p <0.001). Clinical studies contributed to about 86.1\% of the published abstracts. However, publication rates were significantly higher for laboratory studies as compared to clinical studies (70.1\% vs. 50.8\%, p <0.001). Multi-center studies were closer to publication than single-center studies (67.1\% vs. 52.2\%, p=0.009). Our study demonstrated that multi-center studies (odds ratio, 1.81