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    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, Fatih
    Study 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=0.285
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    Does pedicle screw density matter in Lenke type 5 adolescent idiopathic scoliosis?
    (LIPPINCOTT WILLIAMS \& WILKINS, 2018-01-01) Sariyilmaz, Kerim; Ozkunt, Okan; Karademir, Gokhan; Gemalmaz, Halil Can; Dikici, Fatih; Domanic, Unsal
    The aim of this study is to compare the effects of high versus low implant density on correction in Lenke type 5 adolescent idiopathic scoliosis (AIS) patients. A retrospective study of 59 Lenke type 5 AIS patients treated at a single institution were divided into to 2 groups according to implant density. Implant density, preoperative, early postoperative, and last follow-up thoracolumbar/lumbar (TL/L) curves were measured. Thirty-one constructs were high and 28 constructs were low density. The groups were similar in terms of age, sex, Cobb angle, and follow-up time. Mean implant density in low density group and high density group was 75.4\% and 96.6\%, respectively. High versus low-density comparison showed that there is no significant difference with regard to curve correction in early postoperative and last follow-up periods. The results show that pedicle screw density being low or high, does not affect curve correction rates in the short and long term in our patients.
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    Is pharmacological anticoagulant prophylaxis necessary for adolescent idiopathic scoliosis surgery?
    (LIPPINCOTT WILLIAMS \& WILKINS, 2019-01-01) Kochai, Alauddin; Cicekli, Ozgur; Bayam, Levent; Turker, Mehmet; Sariyilmaz, Kerim; Erkorkmaz, Unal
    We report the outcomes of mechanical prophylaxis and chemoprophylaxis in patients who underwent elective surgery for idiopathic adolescent scoliosis (AIS). We retrospectively studied the patients who underwent posterior spinal instrumentation for AIS. The patients were divided into three groups: Group A low-molecular-weight heparin (LMWH) started at 8 hours after surgery
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    A Novel 3D Printed Custom Antibiotic Spacer Mold for Osteomyelitis Cases which are Prone to Instability
    (GAZI UNIV, FAC MED, 2018-01-01) Gemalmaz, Halil Can; Sariyilmaz, Kerim; Ozkunt, Okan; Sungur, Mustafa; Kaya, Ibrahim; Dikici, Fatih
    Presence of complex bone defects in osteomyelitis treatment may be challenging for the surgeon. Antibiotic cement spacers take a role in managing these defects. The available techniques and systems of antibiotic cement spacers have their pros and cons. There are cases in which these standard options may fail, mainly due to stability related issues. In this report, we present an antibiotic spacer technique in a very complex bone defect that is prone to failure if managed by routine spacer applications. Anticipating that any standard spacer application methodology will fail, we decided to make our own custom antibiotic cement spacer. We used the patient's uninjured side's tomography data to create a custom 3D spacer mold model with the help of a computer software. Later this 3D spacer mold model was printed with a 3D printer. The print out was sterilized and used to cast a custom antibiotic cement spacer resulting in a perfect fit in the defect.
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    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, Unsal
    A 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.
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    The effect of tourniquet usage on cement penetration in total knee arthroplasty A prospective randomized study of 3 methods
    (LIPPINCOTT WILLIAMS \& WILKINS, 2018-01-01) Ozkunt, Okan; Sariyilmaz, Kerim; Gemalmaz, Halil Can; Dikici, Fatih
    Background: It is a randomized study to compare cement penetration on x-rays after total knee arthroplasty (TKA) among 3 different ways to use tourniquets