Mercan Sarier - Academia.edu (original) (raw)
Papers by Mercan Sarier
Düşünen Adam: The Journal of Psychiatry and Neurological Sciences, 1990
Spine, 2011
The manuscript submitted does not contain information about medical device(s)/drug(s). No funds w... more The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No benefi ts in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Neurosurgery Quarterly, 2016
The purpose of this retrospective study was to determine the radiologic outcome at the index and ... more The purpose of this retrospective study was to determine the radiologic outcome at the index and adjacent levels and clinical outcome of cervical total disk arthroplasty (TDA) using Prodisc-C after a minimum 24 months follow-up at a single center. Methods: Eighty-six levels of 59 (28 female, 31 male) cases with minimum 2 years follow-up were included in this study. Radiologic parameters including disk level height at the operated and adjacent levels, global cervical lordosis, segmental lordosis, range of motion, subsidence, facet arthrosis, adjacent segment degeneration (ASD), and heterotopic ossification were analyzed. All surgeries were performed by a single surgeon. Results: Average age was 39.5 (range, 27 to 56) years and average follow-up was 33.6 (range, 24 to 81) months. Operated levels were C3-4 (%4.6), C4-5 (%16.3), C5-6 (%48.8), C6-7 (%26.8), and C7-T1 (%3.5). All patients had clinical improvement. NDI was improved from 46 to 9. There was a significant improvement in segmental kyphosis, global lordosis, and disk height at the operated level with no significant change at the final follow-up. There was no radiographic facet joint arthrosis at the index and adjacent levels, 4 (%6.7) patients had radiographic signs of ASD at the cranial adjacent level, whereas 5 (%8.4) patients had ASD at the caudal adjacent level. Heterotopic ossification (HO) was observed in 4 patients (%6.7) with a complete fusion in 1 patient. Conclusions: This study demonstrates a satisfactory radiographic and clinical outcome after prodisc-C TDA with a minimum 24-month follow-up.
European Journal of Orthopaedic Surgery & Traumatology, 2006
The neurological deficit can be seen in severe thoracolumbar kyphosis caused by spinal tuberculos... more The neurological deficit can be seen in severe thoracolumbar kyphosis caused by spinal tuberculosis (early or late onset), fracture and congenital deformities. It is commonly believed that spinal cord compression at the severe kyphotic segment is mainly responsible for the neurological deficit. The purpose of this paper was to describe here a new entity of neurological deficit mechanism due to the thoracic spinal stenosis produced above the severe thoracolumbar kyphosis (transition zone from severe kyphosis to compensatory or structural lordosis). Three patients who were presented with this problem are described. The appropriate surgical treatment revealed the disappearance of the symptoms. We believe in that facet orientation change and direction of them towards spinal canal cause spinal canal stenosis and foraminal stenosis in the compensatory lordotic segment, which eventually becomes structural lordosis above the severe kyphotic segment. These changes result in shearing stresses in long period and cause facet hypertrophy and spinal canal narrowing. Keywords Thoracolumbar kyphosis AE Compensatory lordosis AE Neurological deficit Ste´nose verte´brale thoracique se´ve`re apre`s cyphose thoraco-lombaire Re´sume´Un de´ficit neurologique peut eˆtre constate´dans les hypercyphoses thoraco-lombaires se´ve`res cause´es par la tuberculose verte´brale (de´but pre´coce ou tardif), les fractures et les de´formations conge´nitales. L'on pense habituellement que c'est la compression me´dullaire qui est responsable des de´ficits neurologiques. Le but de ce travail est de mettre en e´vidence un autre me´canisme de de´ficit neurologique produit par une ste´nose sus-jacente a`une se´ve`re hypercyphose thoracolombaire (zone transitionnelle entre l'hypercyphose et la lordose compensatrice ou structurelle). Trois patients pre´sentant une telle le´sion sont pre´sente´s. Le traitement chirurgical approprie´a permis la disparition des symptoˆmes. Nous pensons que c'est le changement d'orientation et de direction des facettes qui est responsable de la ste´nose canalaire et foraminale dans le segment lordotique compensateur, qui peut e´ventuellement se transformer en lordose structurelle au dessus du segment cyphotique. Ces changements re´sultent de stress en cisaillement pendant une longue pe´riode, qui entraıˆnent une hypertrophie des facettes articulaires et un canal e´troit.
European Journal of Orthopaedic Surgery & Traumatology, 2005
Brucellar spondylitis may be difficult to diagnose. Initial plain radiographs of the spine may sh... more Brucellar spondylitis may be difficult to diagnose. Initial plain radiographs of the spine may show mild degenerative lesions. Although, magnetic resonance imaging of spine is mostly helpful to establish the disease, in some cases, it may lead to misdiagnosis. The aim of this report was to present a case of brucella infection involving the cervical spine that was falsely diagnosed and underwent to surgery for cervical disc herniation. Since the spinal form of brucellosis has no specific symptomatology, a patient has symptoms with mimicking the cervical hernia, with a history of disabling pain more severe than radicular pain, and especially who reside in countries where the disease is endemic, the brucella infection should be kept in mind in the differential diagnosis and specific diagnostic investigations such as brucella agglutination tests should be made before any treatment procedure.
Turkish neurosurgery
In extreme rarity, spinal cord compression may be caused by intradural extramedullary cysts. One ... more In extreme rarity, spinal cord compression may be caused by intradural extramedullary cysts. One of these rare cysts, the ependymal cyst originates, from ectopic ependymal fragments situated parallel to the central canal development and may be seen anywhere in the spinal aids. Considering this rarity and reviewing the literature, we present a spinal cord ependymal cyst case along with a discussion of histopathological and surgical findings.
Spine, 2011
The manuscript submitted does not contain information about medical device(s)/drug(s). No funds w... more The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No benefi ts in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Neurosurgery Quarterly, 2016
European Journal of Orthopaedic Surgery & Traumatology, 2006
European Journal of Orthopaedic Surgery & Traumatology, 2005
Brucellar spondylitis may be difficult to diagnose. Initial plain radiographs of the spine may sh... more Brucellar spondylitis may be difficult to diagnose. Initial plain radiographs of the spine may show mild degenerative lesions. Although, magnetic resonance imaging of spine is mostly helpful to establish the disease, in some cases, it may lead to misdiagnosis. The aim of this report was to present a case of brucella infection involving the cervical spine that was falsely diagnosed and underwent to surgery for cervical disc herniation. Since the spinal form of brucellosis has no specific symptomatology, a patient has symptoms with mimicking the cervical hernia, with a history of disabling pain more severe than radicular pain, and especially who reside in countries where the disease is endemic, the brucella infection should be kept in mind in the differential diagnosis and specific diagnostic investigations such as brucella agglutination tests should be made before any treatment procedure.
The Spine Journal, 2006
BACKGROUND CONTEXT: Although thoracic disc herniations are rare, misdiagnosis is an undesirable s... more BACKGROUND CONTEXT: Although thoracic disc herniations are rare, misdiagnosis is an undesirable situation, as it results not only in unnecessary diagnostic studies and surgical procedures, but also in progressive myelopathy and paralysis. Therefore, it is important to be aware of patients with thoracic disc herniations presenting with unusual or atypical symptoms mimicking other nonspinal disorders. PURPOSE: A patient with left flank pain compatible with urinary system disorder, who proved to have thoracic disc herniation, is presented. STUDY DESIGN: Case report METHODS: The cause of the patient's pain could not be elucidated until thoracic spine magnetic resonance imaging revealed a left thoracic 10-11 lateral disc herniation with associated nerve root compression. RESULTS: Conservative therapy including bed rest and analgesic medication was initiated. He had complete pain relief within the same day. CONCLUSION: Thoracic disc herniation should be considered in the differential diagnosis of patients with pain likely caused by nonspinal disorders, especially if basic diagnostic studies do not reveal the cause.
Spine, 2007
Study Design. Retrospective clinical study. Objective. To show retrospective analysis of 21 conse... more Study Design. Retrospective clinical study. Objective. To show retrospective analysis of 21 consecutive patients who underwent simultaneous surgical treatment for progressive spinal deformity and coexisting intraspinal pathologies (tethered cord and/or diastematomyelia). Summary of Background Data. The classic advocated approach in patients with congenital spine deformity associated with intraspinal anomalies is first to perform surgery for the intraspinal pathologies and then surgery for correction and stabilization of the deformity 3 to 6 months later. To our knowledge, there is no study on simultaneous surgical treatment for these 2 associated conditions. Methods. In the surgery; after the exposure of the determined levels, placement of all pedicle screws was performed as the initial part of surgical procedure. Then surgical treatment for intraspinal pathology was performed by the neurosurgical team and then followed by completion of instrumentation and correction of the deformity. Additional anterior surgery was done later to prevent pseudarthrosis and crankshaft phenomenon. Results. The mean age of the patients at presentation ranged from 3 to 19 years (mean, 13 years). There were 17 female patients and 4 male patients. Four patients had neurologic deficits at the time of presentation, and all 4 had associated kyphosis. The mean operation time was 9.3 hours (range, 7-12 hours) and the mean blood loss was 1980 mL (range, 1500-3000 mL). The average follow-up was 6.8 years (2-12 years). None of the patients experienced deterioration in their neurologic status after surgery. None of the patients had infection, pseudarthrosis, or loss of correction during the follow-up visits. Conclusion. The simultaneous surgical treatment for congenital deformity and intraspinal abnormality does not involve significant complications and seems to be an alternative and safe treatment option.
European Spine Journal, 2012
Mutism without any disorder of consciousness level and or cranial deficit following posterior fos... more Mutism without any disorder of consciousness level and or cranial deficit following posterior fossa surgery is not com mon and the re is no definitive aetiological hypothesis. Here we report a case of mutism in a 6-year- old patient after total removal of a posterior fossa medulloblastoma. Mutism was noted
The procedure of posterior endoscopic discectomy (PED) is an attempt to allow for a standard fami... more The procedure of posterior endoscopic discectomy (PED) is an attempt to allow for a standard familiar microsurgical discectomy to be performed using standard microsurgical techniques via a minimally invasive approach. The aim of this study was to evaluate our results with PED for lumbar disc herniation and to assess the advantages, disadvantages and clinical outcomes of the technique. Between February 2002 and August 2004, 71 patients with a mean age of 44 years (range : 24 to 73) underwent PED. The operated disc levels were L5-S1 in 37 patients, L4-L5 in 26 patients and L3-L4 in 8 patients. Mean operative time was 84 min. (41-135 min.). All patients experienced substantial relief of their leg pain immediately after the operation, mobilised very early after recovery from the anaesthesia and were discharged home within 24 hours of surgery with only oral NSAID +/- myorelaxants. PED has advantages like better illumination, better magnification, and better visualisation through the rota...
European Journal of Orthopaedic Surgery Traumatologie, 2006
Eur J Orthop Surg Traumatol, 2007
Düşünen Adam: The Journal of Psychiatry and Neurological Sciences, 1990
Spine, 2011
The manuscript submitted does not contain information about medical device(s)/drug(s). No funds w... more The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No benefi ts in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Neurosurgery Quarterly, 2016
The purpose of this retrospective study was to determine the radiologic outcome at the index and ... more The purpose of this retrospective study was to determine the radiologic outcome at the index and adjacent levels and clinical outcome of cervical total disk arthroplasty (TDA) using Prodisc-C after a minimum 24 months follow-up at a single center. Methods: Eighty-six levels of 59 (28 female, 31 male) cases with minimum 2 years follow-up were included in this study. Radiologic parameters including disk level height at the operated and adjacent levels, global cervical lordosis, segmental lordosis, range of motion, subsidence, facet arthrosis, adjacent segment degeneration (ASD), and heterotopic ossification were analyzed. All surgeries were performed by a single surgeon. Results: Average age was 39.5 (range, 27 to 56) years and average follow-up was 33.6 (range, 24 to 81) months. Operated levels were C3-4 (%4.6), C4-5 (%16.3), C5-6 (%48.8), C6-7 (%26.8), and C7-T1 (%3.5). All patients had clinical improvement. NDI was improved from 46 to 9. There was a significant improvement in segmental kyphosis, global lordosis, and disk height at the operated level with no significant change at the final follow-up. There was no radiographic facet joint arthrosis at the index and adjacent levels, 4 (%6.7) patients had radiographic signs of ASD at the cranial adjacent level, whereas 5 (%8.4) patients had ASD at the caudal adjacent level. Heterotopic ossification (HO) was observed in 4 patients (%6.7) with a complete fusion in 1 patient. Conclusions: This study demonstrates a satisfactory radiographic and clinical outcome after prodisc-C TDA with a minimum 24-month follow-up.
European Journal of Orthopaedic Surgery & Traumatology, 2006
The neurological deficit can be seen in severe thoracolumbar kyphosis caused by spinal tuberculos... more The neurological deficit can be seen in severe thoracolumbar kyphosis caused by spinal tuberculosis (early or late onset), fracture and congenital deformities. It is commonly believed that spinal cord compression at the severe kyphotic segment is mainly responsible for the neurological deficit. The purpose of this paper was to describe here a new entity of neurological deficit mechanism due to the thoracic spinal stenosis produced above the severe thoracolumbar kyphosis (transition zone from severe kyphosis to compensatory or structural lordosis). Three patients who were presented with this problem are described. The appropriate surgical treatment revealed the disappearance of the symptoms. We believe in that facet orientation change and direction of them towards spinal canal cause spinal canal stenosis and foraminal stenosis in the compensatory lordotic segment, which eventually becomes structural lordosis above the severe kyphotic segment. These changes result in shearing stresses in long period and cause facet hypertrophy and spinal canal narrowing. Keywords Thoracolumbar kyphosis AE Compensatory lordosis AE Neurological deficit Ste´nose verte´brale thoracique se´ve`re apre`s cyphose thoraco-lombaire Re´sume´Un de´ficit neurologique peut eˆtre constate´dans les hypercyphoses thoraco-lombaires se´ve`res cause´es par la tuberculose verte´brale (de´but pre´coce ou tardif), les fractures et les de´formations conge´nitales. L'on pense habituellement que c'est la compression me´dullaire qui est responsable des de´ficits neurologiques. Le but de ce travail est de mettre en e´vidence un autre me´canisme de de´ficit neurologique produit par une ste´nose sus-jacente a`une se´ve`re hypercyphose thoracolombaire (zone transitionnelle entre l'hypercyphose et la lordose compensatrice ou structurelle). Trois patients pre´sentant une telle le´sion sont pre´sente´s. Le traitement chirurgical approprie´a permis la disparition des symptoˆmes. Nous pensons que c'est le changement d'orientation et de direction des facettes qui est responsable de la ste´nose canalaire et foraminale dans le segment lordotique compensateur, qui peut e´ventuellement se transformer en lordose structurelle au dessus du segment cyphotique. Ces changements re´sultent de stress en cisaillement pendant une longue pe´riode, qui entraıˆnent une hypertrophie des facettes articulaires et un canal e´troit.
European Journal of Orthopaedic Surgery & Traumatology, 2005
Brucellar spondylitis may be difficult to diagnose. Initial plain radiographs of the spine may sh... more Brucellar spondylitis may be difficult to diagnose. Initial plain radiographs of the spine may show mild degenerative lesions. Although, magnetic resonance imaging of spine is mostly helpful to establish the disease, in some cases, it may lead to misdiagnosis. The aim of this report was to present a case of brucella infection involving the cervical spine that was falsely diagnosed and underwent to surgery for cervical disc herniation. Since the spinal form of brucellosis has no specific symptomatology, a patient has symptoms with mimicking the cervical hernia, with a history of disabling pain more severe than radicular pain, and especially who reside in countries where the disease is endemic, the brucella infection should be kept in mind in the differential diagnosis and specific diagnostic investigations such as brucella agglutination tests should be made before any treatment procedure.
Turkish neurosurgery
In extreme rarity, spinal cord compression may be caused by intradural extramedullary cysts. One ... more In extreme rarity, spinal cord compression may be caused by intradural extramedullary cysts. One of these rare cysts, the ependymal cyst originates, from ectopic ependymal fragments situated parallel to the central canal development and may be seen anywhere in the spinal aids. Considering this rarity and reviewing the literature, we present a spinal cord ependymal cyst case along with a discussion of histopathological and surgical findings.
Spine, 2011
The manuscript submitted does not contain information about medical device(s)/drug(s). No funds w... more The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No benefi ts in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Neurosurgery Quarterly, 2016
European Journal of Orthopaedic Surgery & Traumatology, 2006
European Journal of Orthopaedic Surgery & Traumatology, 2005
Brucellar spondylitis may be difficult to diagnose. Initial plain radiographs of the spine may sh... more Brucellar spondylitis may be difficult to diagnose. Initial plain radiographs of the spine may show mild degenerative lesions. Although, magnetic resonance imaging of spine is mostly helpful to establish the disease, in some cases, it may lead to misdiagnosis. The aim of this report was to present a case of brucella infection involving the cervical spine that was falsely diagnosed and underwent to surgery for cervical disc herniation. Since the spinal form of brucellosis has no specific symptomatology, a patient has symptoms with mimicking the cervical hernia, with a history of disabling pain more severe than radicular pain, and especially who reside in countries where the disease is endemic, the brucella infection should be kept in mind in the differential diagnosis and specific diagnostic investigations such as brucella agglutination tests should be made before any treatment procedure.
The Spine Journal, 2006
BACKGROUND CONTEXT: Although thoracic disc herniations are rare, misdiagnosis is an undesirable s... more BACKGROUND CONTEXT: Although thoracic disc herniations are rare, misdiagnosis is an undesirable situation, as it results not only in unnecessary diagnostic studies and surgical procedures, but also in progressive myelopathy and paralysis. Therefore, it is important to be aware of patients with thoracic disc herniations presenting with unusual or atypical symptoms mimicking other nonspinal disorders. PURPOSE: A patient with left flank pain compatible with urinary system disorder, who proved to have thoracic disc herniation, is presented. STUDY DESIGN: Case report METHODS: The cause of the patient's pain could not be elucidated until thoracic spine magnetic resonance imaging revealed a left thoracic 10-11 lateral disc herniation with associated nerve root compression. RESULTS: Conservative therapy including bed rest and analgesic medication was initiated. He had complete pain relief within the same day. CONCLUSION: Thoracic disc herniation should be considered in the differential diagnosis of patients with pain likely caused by nonspinal disorders, especially if basic diagnostic studies do not reveal the cause.
Spine, 2007
Study Design. Retrospective clinical study. Objective. To show retrospective analysis of 21 conse... more Study Design. Retrospective clinical study. Objective. To show retrospective analysis of 21 consecutive patients who underwent simultaneous surgical treatment for progressive spinal deformity and coexisting intraspinal pathologies (tethered cord and/or diastematomyelia). Summary of Background Data. The classic advocated approach in patients with congenital spine deformity associated with intraspinal anomalies is first to perform surgery for the intraspinal pathologies and then surgery for correction and stabilization of the deformity 3 to 6 months later. To our knowledge, there is no study on simultaneous surgical treatment for these 2 associated conditions. Methods. In the surgery; after the exposure of the determined levels, placement of all pedicle screws was performed as the initial part of surgical procedure. Then surgical treatment for intraspinal pathology was performed by the neurosurgical team and then followed by completion of instrumentation and correction of the deformity. Additional anterior surgery was done later to prevent pseudarthrosis and crankshaft phenomenon. Results. The mean age of the patients at presentation ranged from 3 to 19 years (mean, 13 years). There were 17 female patients and 4 male patients. Four patients had neurologic deficits at the time of presentation, and all 4 had associated kyphosis. The mean operation time was 9.3 hours (range, 7-12 hours) and the mean blood loss was 1980 mL (range, 1500-3000 mL). The average follow-up was 6.8 years (2-12 years). None of the patients experienced deterioration in their neurologic status after surgery. None of the patients had infection, pseudarthrosis, or loss of correction during the follow-up visits. Conclusion. The simultaneous surgical treatment for congenital deformity and intraspinal abnormality does not involve significant complications and seems to be an alternative and safe treatment option.
European Spine Journal, 2012
Mutism without any disorder of consciousness level and or cranial deficit following posterior fos... more Mutism without any disorder of consciousness level and or cranial deficit following posterior fossa surgery is not com mon and the re is no definitive aetiological hypothesis. Here we report a case of mutism in a 6-year- old patient after total removal of a posterior fossa medulloblastoma. Mutism was noted
The procedure of posterior endoscopic discectomy (PED) is an attempt to allow for a standard fami... more The procedure of posterior endoscopic discectomy (PED) is an attempt to allow for a standard familiar microsurgical discectomy to be performed using standard microsurgical techniques via a minimally invasive approach. The aim of this study was to evaluate our results with PED for lumbar disc herniation and to assess the advantages, disadvantages and clinical outcomes of the technique. Between February 2002 and August 2004, 71 patients with a mean age of 44 years (range : 24 to 73) underwent PED. The operated disc levels were L5-S1 in 37 patients, L4-L5 in 26 patients and L3-L4 in 8 patients. Mean operative time was 84 min. (41-135 min.). All patients experienced substantial relief of their leg pain immediately after the operation, mobilised very early after recovery from the anaesthesia and were discharged home within 24 hours of surgery with only oral NSAID +/- myorelaxants. PED has advantages like better illumination, better magnification, and better visualisation through the rota...
European Journal of Orthopaedic Surgery Traumatologie, 2006
Eur J Orthop Surg Traumatol, 2007