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Item Azathioprine as a Neuroprotective Agent in Experimental Traumatic Spinal Cord Injury(TURKISH NEUROSURGICAL SOC, 2021-01-01) Bahadir, Sinan; Onal, Mehmet Bulent; Narin, Firat; Basar, Ibrahim; Yigitkanli, Kazim; Bavbek, Murad; Ziyal, Mustafa IbrahimAIM: To evaluate the protective effects of azathioprine, a macrophage-inhibiting agent, on secondary injury in spinal cord trauma. MATERIAL and METHODS: A total of 40 Wistar rats were randomly divided into 4 groups. All the animals had undergone T8-10 laminectomy. Except in group I (control), all the animals were exposed to spinal cord trauma at the T9 level. Animals in group II (trauma) received no treatment following trauma. Animals in group 3 (treatment) and group IV (vehicle) were given intraperitoneal azathioprine 4 mg/kg and saline 2 ml, respectively, 30 minutes after the trauma. Half of the animals in each group were sacrificed 24 hours after injury and specimens were used for biochemical and immunohistochemical evaluations. The rest of the animals were followed-up for 4 weeks in terms of neurological functions and were also sacrificed to perform the histopathological analysis. RESULTS: Significant decrease in apoptotic cells and improved neurological function were observed in the animals treated with azathioprine. Biological and immunohistochemical analysis also showed less oxidative stress in this group compared to those without treatment. CONCLUSION: Azathioprine, a potent macrophage-inhibiting agent, has been shown to decrease the extent of secondary injury following spinal cord trauma.Item The Rae of Spondylodiscitis in Patients with Lomber Discectomy Using Single Dose Prophylactic is Antibiotics(GALENOS YAYINCILIK, 2019-01-01) Diren, Furkan; Onal, Mehmet Bulent; Can, Halil; Kircelli, AtillaObjective: The incidence of spondylodiscitis following lumbar discectomy has been reported to range between 0.1\% and 18.8\% by various authors. The most common pathogen is Staphylococcus aureus. Methods: We collected retrospectively the medical records of 1154 patients who had the single-level or two-level disc herniation and were operated for lumbar microdiscectomy between 2007 and 2015 in our hospital. Of them, 554 were female and 600 were male. A total of 1062 patients underwent single-level, 91-level two-level lumbar microdiscectomy. All of these patients were given prophylactic single-dose cefazoline sodium during anesthesia in accordance with the recommendations of the surgical antimicrobial prophylaxis guidelines. Spondylodiscitis developed in 12 patients (1.03\%). The comorbidities in patients treated for spondylodiscitis, isolated pathogens, antibiotic susceptibility, antibiotics used, and hospital stay were recorded. Results: Of the 12 patients, 7 were female and 5 were male. The mean age was 45.75 +/- 14.16 years. Eleven patients underwent single-level, and 1 two-level lumbar microdiscectomy procedures. 5 patients underwent discectomy from L4-5 and 8 patients from L5-S1 levels. Staphylococcus aureus was present in 3 patients (25\%), Staphylococcus epidermidis in 4 (33\%), Escherichia coil in 3 (25\%), and 2 patients had no detected pathogens. The mean duration of hospital stay was 29.45 +/- 3.98 days, and in patients without spondylodiscitis, it was 1.99 +/- 0.81 days, meaning that there was a significant difference between these groups (p=0.0001). Conclusion: Although most surgeons tend to maintain antibiotic prophylaxis postoperatively or during the hospitalization period, our study found that a single dose prophylactic antibiotic administered during anesthesia induction did not increase the rate of spondylodiscitis, compared to the results found in the medical literature.Item The Effect of Using a Dose of Prophylactic Antibiotics on Spondylodiscitis in Lumbar Disc Surgery(GALENOS YAYINCILIK, 2020-01-01) Diren, Furkan; Onal, Mehmet Bulent; Can, Halil; Kircelli, AtillaObjective: Although spondylodiscitis seen after lumbar discectomy is very rare, its incidence has been reported to be around 0.1-18.8\% by many different authors. The most common pathogen is Staphylococcus aureus. Methods: Medical records of 1,154 patients who were operated in our hospital between 2007 and 2015 due to a single or two-level lumbar disc hernia were retrospectively extracted. Of these patients, 554 were female and 600 were male. Discectomy operation was performed in 1,062 of these patients with single-level and 91 with two-level lumbar microdiscectomy. All of these patients were given a prophylactic single dose of cefazolin sodium in accordance with the recommendations of the surgical antimicrobial prophylaxis guidelines during anesthesia. Spondylodiscitis developed in 12 patients (1.03\%). Comorbidities in patients who developed spondylodiscitis, isolated pathogens, antibiotic susceptibility, antibiotics used, and hospital stay were noted. Results: Of the 12 patients, 7 were female and 5 were male. Mean age was 45.75 +/- 14.16 years. Eleven of these patients underwent single level, one had 2 levels of lumbar microdiscectomy. Five patients underwent discectomy at L4-5 and 8 patients at L5-S1 levels. Three of these patients had S. aureus (25\%), 4 had Staphylococcus epidermidis (33\%) and 3 had Escherichia coli (25\%) and 2 patients had no reproduction. The mean hospital stay was 29.45 +/- 3.98, and in patients without spondylodiscitois it was 1.99 +/- 0.81, the two groups were significantly different from each other (p=0.0001). Conclusion: Although most surgeons nave a tendency to maintain antibiotic prophylaxis postoperatively or during hospitalization period, our study found that a single dose prophylactic antibiotic administered during anesthesia induction did not increase rate of spondylodiscitis by medical literature.Item The C2-Pars Interarticularis Screw as an Alternative in Atlanto-Axial Stabilization. A Biomechanical Comparison of Established Techniques(TURKISH NEUROSURGICAL SOC, 2018-01-01) Schleicher, Philipp; Onal, Mehmet Bulent; Hemberger, Frank; Scholz, Matti; Kandziora, FrankAIM: To compare four different atlantoaxial stabilization techniques. MATERIAL and METHODS: Eight human cervical spines (segments C0-C3) were tested in flexion/extension, lateral bending and axial rotation. Range of Motion (ROM) at a 1.5 Nm load was recorded. After native testing, the Harms (HARMS), pars screw (PARS), intralaminar screw (INTRA) and anterior transarticular screw (ATA) constructs were applied in a random order. RESULTS: FLEXION/EXTENSION: mean ROM (+/- SD) in native state was 15.9 degrees (+/- 7.6 degrees)