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Item Influence of Distal Fusion Level on Sagittal Spinopelvic and Spinal Parameters in the Surgical Management of Adolescent Idiopathic Scoliosis(KOREAN SOC SPINE SURGERY, 2018-01-01) Akgul, Turgut; Sariyilmaz, Kerim; Korkmaz, Murat; Ozkunt, Okan; Kaya, Ozcan; Dikici, FatihStudy Design: trospective analysis of adolescent idiopathic scoliosis. Purposep: s study aimed to investigate the influence of distinct distal fusion levels on spinopelvic parameters in patients with adolescent idiopathic scoliosis (AIS) who underwent posterior instrumentation and fusion surgery. Overview of Literature: e distal fusion level selection in treatment of AIS is the one of milestone to effect on surgical outcome. Most of the paper focused on the coronal deformity correction and balance. The literature have lack of knowledge about spinopelvic changing after surgical treatment and the relation with distal fusion level. We evaluate the spinopelvic and pelvic parameter alteration after fusion surgery in treatment of AIS. Methods: total of 100 patients with AIS (88 females and 12 males) were retrospectively reviewed. Patients were assigned into the following three groups according to the distal fusion level: lumbar 2 (L2), lumbar 3 (L3), and lumbar 4 (L4). Using a lateral plane radiograph of the whole spine, spinopelvic angular parameters such as thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were radiologically assessed. Results: e mean age was 15+/-2.4 years, and the mean follow-up period was 24.27+/-11.69 months. Regarding the lowest instrumented vertebra, patients were categorized as follows: 30 patients in L2 (group 1), 40 patients in L3 (group 2), and 30 patients in L4 (group 3). TK decreased from 36.60+/-13.30 degrees preoperatively to 26.00+/-7.3 degrees postoperatively in each group (p=0.001). LL decreased from 52.8+/-9.4 degrees preoperatively to 44.30+/-7.50 degrees postoperatively (p=0.001). Although PI showed no difference preoperatively among the groups, it was statistically higher postoperatively in group 3 than in the other groups (p<0.05). In addition, in group 2, PI decreased from 50.60+/-8.74 degrees preoperatively to 48.00+/-6.84 degrees postoperatively (p=0.027). SS decreased from 35.20+/-6.40 degrees preoperatively to 33.40+/-5.80 degrees postoperatively (p=0.08, p>0.05). However, mean SS was significantly higher in group 3 (p=0.042, p<0.05). PT decreased from 15.50+/-7.90 degrees preoperatively to 15.2+/-7.10 degrees postoperatively. The positive relationship (28.5\%) between LL and PI measurements was statistically significant (r=0.285Item Comparison of fixation techniques in Vancouver type AG periprosthetic femoral fracture: a biomechanical study(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2016-01-01) Sariyilmaz, Kerim; Korkmaz, Murat; Ozkunt, Okan; Gemalmaz, Hall Can; Sunguill, Mustafa; Baydogan, Murat; Kaya, Ibrahim; Okla, FatihObjective: The purpose of this study was to biomechanically compare cable, trochanteric grip plate, and locking plate techniques in Vancouver type AG fracture model in an in vitro test environment. Methods: Fifteen pieces of fourth-generation synthetic femora were separated into 3 groups of 5 models each. A greater trochanteric fracture model was created after femoral stem implantation. Group 1 was fixated with only cable, Group 2 with trochanteric grip plate, and Group 3 with locking plate. Horizontal stiffness, axial stiffness, and failure loads were compared between the groups. Results: In horizontal compression tests, Group 3 had the highest values, but the only statistically significant difference was between the locking plate group and cable group. Axial distraction test results showed that mean stiffness of Group 1 was 94.6 +/- 9.44 N/mm, that of Group 2 was 174.8 +/- 28.64 N/mm, and that of Group 3 was 185.6 +/- 71.64 N/mm. While locking plate versus cable fixation and grip plate fixation versus cable fixation showed statistically significant differences (p<0.05), comparison of locking plate versus grip plate fixation showed no statistically significant difference (p>0.05). In axial failure load test, Group 3 had the highest results. The only significant difference was between the locking plate and cable groups (p<0.05). Conclusion: In Vancouver type AG fractures stable fixation may be achieved with grip plate fixation and locking plates, with the former ensuring more stable osteosynthesis.Item Selection of distal fusion level in terms of distal junctional kyphosis in Scheuermann kyphosis. A comparison of 3 methods(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2018-01-01) Dikici, Fatih; Akgul, Turgut; Sariyilmaz, Kerim; Korkmaz, Murat; Ozkunt, Okan; Sar, Cuneyt; Domanic, UnsalObjective: The aim of this study was to investigate the effect of distal fusion level selection on the distal junctional kyphosis (DJK) in Scheuermann kyphosis (SK) patients who underwent posterior fusion. Methods: Thirty-nine SK patients who underwent posterior fusion with a minimum follow-up of 3 years were retrospectively evaluated. According to the distal fusion level, patients were divided into 3 groups. Group SItem Surgical Approach Algorithm in the Treatment of Lumbar and Thoracolumbar Pyogenic Spondylodiscitis(TURKISH NEUROSURGICAL SOC, 2022-01-01) Akgul, Turgut; Bayram, Serkan; Korkmaz, Murat; Karalar, Sahin; Dikici, Fatih; Sar, CuneytAIM: To reveal the efficiency of our surgical approach algorithm in patients with thoracolumbar pyogenic spondylodiscitis based on the involvement of anatomical structure. MATERIAL and METHODS: Data of patients who underwent debridement or stabilization surgery for thoracolumbar pyogenic spondylodiscitis from January 2012 to December 2018 were reviewed. Lumbar and thoracolumbar spondylodiscitis was classified into four stages based on anatomical involvement. Infection was limited in the disc space, which had not spread to the endplate in stage 1 and progressed as two-level corpus involvement of >1/2 of vertebral corpus bony destruction or as failed treatment in stage 4. Neurological function was evaluated using Frankel's grading postoperatively. Functional outcomes were categorized according to the Kirkaldy-Willis criteria. RESULTS: The study included 39 patients, with a mean age of 58.2 years. Of these patients, 10, 12, 13, and 4 had stages 1, 2, 3, and 4 spondylodiscitis, respectively. The mean follow-up period was 60.2 (12-184) months. All patients with stages 1 and 2 spondylodiscitis had grade E injuryItem Aarskog-Scott syndrome: An unusual cause of scoliosis(MEDKNOW PUBLICATIONS \& MEDIA PVT LTD, 2017-01-01) Sariyilmaz, Kerim; Ozkunt, Okan; Korkmaz, Murat; Dikici, Fatih; Domanic, UnsalA 16-year-old boy who had been diagnosed previously as Aarskog-Scott syndrome (AAS), referred to our clinic with shoulder asymmetry for 1 year. Results of spine examination showed a 52 degrees right thoracic curve at T3-T11. Surgery was planned, and T1-L1 posterior instrumentation and fusion were performed. After surgery, satisfactory correction was achieved, and during 10 years follow-up, the patient had no complaints. AAS is a X-linked genetic disorder with facial, genital, and skeletal manifestations. Scoliosis is not reported as a typical finding of AAS, and there is no reported case in the English literature. Due to mutation affecting the developing skeleton tissue, spinal deformities may develop. In our case, concave side fusion was seen at the deformity. Although we do not know any specific pattern of the scoliotic deformity of this syndrome, surgical correction of the deformity can be difficult because of the premature fusion at these levels.