Sedat Çağlı - Academia.edu (original) (raw)

Papers by Sedat Çağlı

Journal of Neurological Sciences-turkish, 2013

WOS: 000323600800012Morphometrical analysis of 30 dry stored atlas (C1) vertebrae was performed i... more WOS: 000323600800012Morphometrical analysis of 30 dry stored atlas (C1) vertebrae was performed in order to determine the appropriate length of the screws to be placed on the atlas via posterior approach. In addition, a 3D CT scanning was performed on all samples and angles and lengths were measured on radiological data derived from CT scans. The previous morphometric studies carried out on C1 screw fixation were meticulously reviewed. The literature review has revealed that two non-assessed measurement parameters akin to the ideal screw length have been generated in this study. The first of these parameters, the length of the screw in the saggital plane, has been found 17.8 mm on right and 18.72 mm on left sides. The length of the screw in the vertical plane was found 19.06 mm on right and 19.26 mm on left sides. It's clear that the differences between the interval values of the two measurement parameters range between 5.65 mm and 9.25 mm at minimum. According to the measurements and the literature review carried out so far, there is not a standard screw length for C1 lateral mass screwing technique. The screw length is different for every individual. The surgeon to apply C1 lateral mass screwing must calculate the appropriate screw length via pre-operative cervical CT examinations and use the appropriate-sized screws in the operations

European Journal of Rhinology and Allergy, 2018

Objective: Chordoma is a rare, primary malignant bone tumor derived from primitive notochord remn... more Objective: Chordoma is a rare, primary malignant bone tumor derived from primitive notochord remnants in the skull base. Chordomas are slow-growing, low-grade neoplasms that are more likely to cause local recurrence, but distant metastases are uncommon. The aim of this study was to report the preoperative and postoperative results of chordoma patients who underwent endoscopic endonasal surgery. Material and Methods: This study included 10 patients (8 female and 2 male) who underwent endoscopic endonasal pituitary surgery due to chordoma in the Neurosurgery and Otolaryngology Departments of a tertiary medical center between May 2014 and August 2017. All data were obtained from patients' folders and hospital information system retrospectively by evaluating complaints, operation notes, pathology results, radiological images, and postoperative control notes. Patients were evaluated in the postoperative period for a relapse or residual tumor, additional treatment, postoperative complications, and complaints which is regressed or not. Results: The mean age was 51 years (range, 16-79). Patients were admitted to the Otolaryngology Clinic with headache reported in 2 patients, vision loss in 1 patient, vision loss with headache in 6 patients, and nasal obstruction and headache in 1 patient. A physical examination showed the abducens paralysis in 3 patients and occulomotorius paralysis in 1 patient due to tumor indentation. All patients underwent endoscopic endonasal transethmoid and transsphenoid surgery. Complete gross tumor removal was achieved with the transsphenoidal approach in 9 patients, and the transsphenoidal and far-lateral transcondylar approach in 1 patient. Conclusion: Considering the local aggressive nature of tumor, radical surgery and adjuvant radiotherapy are the main treatments modalities of chordomas located in the skull base. The endoscopic endonasal transsphenoidal approach has become the gold standard method in daily practice due to its reliability and minimal morbidity.

Surgical and Radiologic Anatomy, 2009

Veli ÇITIŞLI, Nevhis AKINTÜRK, Hasan KANYILMAZ, Sedat ÇAĞLI, Mehmet ZİLELİ Chiropractic manipulat... more Veli ÇITIŞLI, Nevhis AKINTÜRK, Hasan KANYILMAZ, Sedat ÇAĞLI, Mehmet ZİLELİ Chiropractic manipulation is considered as a way of treatment for patients who have neck pain without any neurological symptoms. However complications of spinal manipulation are usually underestimated and could be dangerous especially when performed by non-trained personnel. Following the sudden onset of spinal manipulation, massage this paper, we identified 33 year-old man presented a case of quadriplegia C8.MRI scans showed cervical stenosis with C6-T1 right para central disc herniation. Key words: Chiropractic manipulation,quadriplegia,C6-

Turkish neurosurgery, 2013

Primary spinal glioblastoma multiforme (spinal GBM) is not a very common entity. This paper prese... more Primary spinal glioblastoma multiforme (spinal GBM) is not a very common entity. This paper presents an outline of this rare neoplasm, its clinical presentation, course, management and outcome and reports a 3-case series of spinal GBM. In this 3-case series with spinal GBM, one of the patients was operated for hydrocephalous 10 months later following the tumor surgery and another patient had cerebral metastasis after the surgery. In the postoperative period, two of the cases received radiotherapy and one received combined radiotherapy and chemotherapy with steroid therapy together following the tumor surgery. The review of the pertinent literature has revealed that due to the scarcity of the reported cases of primary spinal GBMs, this issue requires a closer look. GBM behaves more aggressive in medulla spinalis than it behaves when it originates from cerebrum. It may disseminate to the cerebrum during its course and it may cause hydrocephalus due to this dissemination (metastasis).

Turkish neurosurgery, 2009

Chordoma is known to be the most common primary tumor of the sacrum. Its surgery is challenging f... more Chordoma is known to be the most common primary tumor of the sacrum. Its surgery is challenging from many aspects. A large amount of bleeding is one of the biggest issues. A 52-year-old woman was admitted to our clinic with a huge mass at sacrum. The mass was diagnosed as chordoma after a needle biopsy. Prior to the surgery, a balloon dilation catheter (BDC) was placed in the distal abdominal aorta via the femoral artery. Just after the skin incision, the BDC was inflated with contrast medium and total occlusion of the aorta was achieved. At the end of the operation we observed that total hemorrhage had decreased dramatically. No complications were recorded except hypertension during the occlusion of the aorta which was expected. The patient was discharged after two weeks of hospitalization post-operatively without any neurological deficit. Our report is the second in the neurosurgical literature to our knowledge. Although this result is preliminary and needs to be replicated and ex...

Turkish neurosurgery, 2007

We report a C2 tear-drop fracture of a 69-year-old patient which occurred after a fall. Although ... more We report a C2 tear-drop fracture of a 69-year-old patient which occurred after a fall. Although tear drop fractures of the subaxial cervical spine mostly develop due to a flexion type injury, the mechanism is often compressive hyperextension injury at the C2 vertebra. Rigid external stabilization and internal fixation are the treatment alternatives. Internal fixation may be performed using the posterior or anterior approach. This paper describes a C2 tear drop fracture which was treated with an anterior plate fixation.

Journal of neuroradiology. Journal de neuroradiologie, 2001

We present the MRI findings in a case of a 24-year-old woman with spinal hemangioblastoma, causin... more We present the MRI findings in a case of a 24-year-old woman with spinal hemangioblastoma, causing neural foraminal widening by producing a dumbbell mass in the lower cervical region. Hemangioblastomas can very rarely present as an intradural extramedullary lesions and this case is another exceptional pathology which should be considered among the differential diagnosis of enlarged intervertebral foramen due to neoplastic processes.

Turkish Neurosurgery, 2010

AIM: Vertebroplasty (VP) and kyphoplasty (KP) are minimally invasive methods for the treatment of... more AIM: Vertebroplasty (VP) and kyphoplasty (KP) are minimally invasive methods for the treatment of vertebral compression fractures (VCF). In this study, we aimed to present our experience with VP and KP performed under local anesthesia and percutaneously. MATeRIAL and MeTHodS: Between 2002 and 2008, 91 patients (total 112 vertebrae) with VCF due to osteoporosis, tumor and trauma underwent VP or KP. After radiological and routine evaluations, all patients were operated under local anesthesia. Mean operation time was 20 minutes per vertebrae. We never stopped the operation because of intolerance of any patient and all of them were discharged on the day of operation or the next day except one. ReSULTS: All patients had severe back pain. Mean preoperative Visual Analogue Scale (VAS) score for pain was 8.3 and the mean postoperative value was 2.7. Mean anterior wall and mid-vertebral body heights increased by 32% and 43%, respectively. The mean kyphotic angle decreased from 15.4 to 11.2. Cement leakage was observed in 4 patients and one of them underwent an open operation (decompression and stabilization) because of cement leakage to the epidural space. There was no other complication. CoNCLUSIoN: Vertebroplasty and kyphoplasty are safe, effective and minimally invasive procedures. Elderly patients can thefore avoid the potential complications of general surgery and be mobilized and discharged early.

The Spine Journal, 2007

Primary tumors of the cervical spine are rare, and many issues regarding their surgical managemen... more Primary tumors of the cervical spine are rare, and many issues regarding their surgical management remain unanswered yet. To demonstrate results of surgery for primary tumors of the cervical spine and to elucidate which factors influence outcome. Retrospective study. Sixty-six surgeries were performed on 35 patients, ranging in age from 7 to 70 years. Preoperative and postoperative degree of pain and neurological status were quantified. Radiological investigations were used to detect recurrence and evaluate the stability and fusion. Data were collected on patient characteristics, therapy, and results. Follow-up ranged from 6 months to 15 years (mean 59.9 months). Posterior (26), anterolateral (24), retropharyngeal (9), combined (4), lateral (2), and transmandibular approaches (1) were used. Chordomas (n=8) and 17 different types of tumors were encountered. One patient died 3 weeks postoperatively and 5 died of their disease at follow-up. Twenty patients had no evidence of disease, and 7 patients had recurrent tumors. According to the Weinstein-Boriani-Biagini classification, tumor extension into both anterior and posterior columns of a vertebra was correlated with a poor outcome. Incomplete resections resulted in tumor recurrence which warranted subsequent surgeries (up to 9), especially in chordoma cases. Complete tumor resection is the oncologically best surgical strategy and should be attempted whenever possible. However, this may not be feasible in every case because of the complexity of the cervical spine. In these cases, acceptable mortality-morbidity rates and symptom-free years could be achieved by subtotal resections, even for malignant tumors.

Neurosurgery Quarterly, 2015

ABSTRACT

Journal of Spinal Disorders & Techniques, 2002

Ventral brainstem compression is common in patients with basilar invagination associated with typ... more Ventral brainstem compression is common in patients with basilar invagination associated with type I Chiari malformation. The aim of this study was to investigate the reliability of a combined one-session anterior-posterior surgical approach for these patients. Nine patients underwent transoral odontoidectomy, posterior foramen magnum decompression, occipitocervical fixation, and bone grafting. All but two patients had ventral and dorsal operations in one surgical sitting. One of these two individuals had previously undergone posterior decompressive surgery at another hospital, but his condition had deteriorated rapidly afterward. The mean follow-up time was 19 months (range, 14-30 months). There was no mortality and no significant morbidity in this series. All but one of the patients showed significant improvement in their symptoms. Chiari malformations have a surprisingly high association with basilar invagination, and patients may have symptoms in both conditions. If there is a marked anterior compression, anterior transoral and posterior decompression, fusion, and instrumentation is an optimal strategy for treating patients with basilar invagination associated with type I Chiari malformation.

Journal of Neurosurgery, 2001

Object. Vasospasm as a complication of subarachnoid hemorrhage is a major concern in clinical pra... more Object. Vasospasm as a complication of subarachnoid hemorrhage is a major concern in clinical practice. The systemic drugs in current use are of limited value. Topical, intrathecal, or intraarterial papaverine administered during surgical or angiographic procedures is a potent vasodilating drug; however, hypotension limits its systemic application. Local application of papaverine in a biodegradable controlled- or sustained-release matrix is proposed for vasospasm prophylaxis to be used in patients scheduled for aneurysm surgery. Methods. Controlled-release papaverine (PapaCR) drug pellets were prepared using the biodegradable aliphatic polyester poly(DL-lactide-co-glycolide) as the carrier matrix. In vitro tests were performed to determine drug kinetics. One hundred seventeen patients, 73 assigned to the control group and 44 assigned to the PapaCR-treated group, participated in this study. Patients who were deemed to be at high risk for the development of vasospasm were selected to ...

European Spine Journal, 2007

We report a case of L4-L5 traumatic anterolisthesis. The patient was treated surgically 4 months ... more We report a case of L4-L5 traumatic anterolisthesis. The patient was treated surgically 4 months after the injury. His radiological and operative findings showed L4 inferior facet tip fracture, L4-L5 anterior displacement and left L4-L5 foraminal disc protrusion. Decompression, reduction with L3, L4, L5 pedicular screw fixation, L4-L5 disc excision and interbody cage insertion with autologous bone grafts were done. Flexion type injury was thought to be the probable mechanism.

Clinical Anatomy, 2009

To reduce the risk of iatrogenic injury to sympathetic chain during anterior and anterolateral ap... more To reduce the risk of iatrogenic injury to sympathetic chain during anterior and anterolateral approaches to the cervical spine, its location has to be well defined and known by surgeons. We analyzed the course of sympathetic chain and its ganglia from C7 up to its entry into the cranial base and its relationship mainly with the longus colli (LC). Formalin fixed 20 human cadavers were dissected under operating microscope. Measurement of the dimensions of the ganglia, distance of the trunk to the LC, and the angles identifying the course of the chain were performed. Superior and inferior cervical/cervicothoracic ganglion were observed in all specimens, the middle cervical ganglion was observed in 48% of the specimens. The middle ganglion consisted of two ganglia in 10% of the dissected sides. Forty percent of the inferior cervical/cervicothoracic ganglion was at the C7 level, 25% was at C7-Th1 disc level, and 35% was at Th1 level. Vertebral ganglion was detected in only 8% of the specimens. The course of the sympathetic trunk converges medially descending from upper cervical levels to the lower levels. Anterior surgical approach to the cervical spine is a commonly used procedure. Although Horner syndrome due to sympathetic injury is not a common sequence of cervical operations, our findings support the current few reports on the subject and should be useful to any surgeon who operates in the cervical region to avoid this uncommon complication.

Clinical Anatomy, 2008

The conventional approach to the fourth ventricle is by splitting the vermis on the suboccipital ... more The conventional approach to the fourth ventricle is by splitting the vermis on the suboccipital surface of the cerebellum. By a unilateral transcerebellomedullary fissure approach, it is possible to provide sufficient operative space from cerebral aqueduct to obex without splitting the vermis. This approach needs meticulous dissection of the cerebellomedullary fissure and preservation of the posterior inferior cerebellar artery (PICA) and its branches. The tonsillomedullary and telovelotonsillar segments of the PICA are the most important vessels encountered in the transcerebellomedullary fissure approach. The PICA was examined under a surgical microscope in a total of 40 specimens by perfusing with a mixture of 10% Indian ink and gelatin. The passing of the tonsillomedullary segment of the PICA through the cerebellomedullary fissure was observed superior to the tonsil in 5%, at the level of the upper pole of the tonsil in 17.5%, at the middle of the tonsil in 37.5% and at the leve...

Clinical Anatomy, 2007

The posterior inferior cerebellar artery (PICA) is the largest branch of the vertebral artery. It... more The posterior inferior cerebellar artery (PICA) is the largest branch of the vertebral artery. It usually arises at the anterolateral margin of the medulla oblongata close to the lower cranial nerves. The PICA had the most complex relationship to the cranial nerves of any artery and it is frequently exposed in approaches directed to the fourth ventricle. The aim of this article is to describe the anatomical relationship of the PICA to the lower cranial nerves. In this study, 12.5% of PICAs passed between the glossopharyngeal and vagus nerves, 20% between the vagus and accessory nerves, and 65% through the rootlets of the accessory nerve. The lateral medullary segment of the PICA showed a lateral loop which in 20% specimens pressed against the inferior surfaces of the facial and vestibulocochlear nerves. The lateral medullary segment of the PICA in 20% specimens passed superior to the hypoglossal nerve, in 47.5% through the rootlets of the hypoglossal nerve, and in 30% inferior to the hypoglossal nerve. The findings on the relationship of the PICA to the lower cranial nerves could be helpful in microsurgery of this region.

Acta Dermato Venereologica, 2010