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    The posterior surgical treatment and outcomes of cervical spondylotic myelopathy: Why not C5 nerve root palsy occur
    (2021) Yuce, Ismail; Kahyaoglu, Okan; Ataseven, Muzeyyen; Cavusoglu, Halit; Aydin, Yunus
    Aim: Cervical spondylotic myelopathy is an age-related degenerative spinal pathology. Anterior or posterior approaches are preferred for surgical treatment. C5 palsy is a common complication after the posterior approach. The aim of our study is to describe the modified laminectomy technique, evaluate short-time surgical outcomes and comment on the C5 nerve root palsy formation. Materials and Methods: 83 patients who had been treated by modified laminectomy for cervical spondylotic myelopathy between the years 2012 and 2017 in our clinic were undertaken in our study. We evaluated the preoperative and postoperative neurologic status of the patients with VAS and JOA scales, complications (C5 palsy) of surgical treatment. The posterior approach was not performed at patients with a >13 degree angle of cervical curvature. Results: 61 of 83 patients were male and 22 were female. The mean age at the time of surgery was 57.8±8.3. The average JOA scale score was 9.4±0.9 preoperatively, 10.1±.0.9 early postoperatively and 15.1±1.0 during the late postoperative follow-up. The average angle of the cervical curvature preoperatively-postoperatively was 17.1±2.6 and 15.8±2.4 respectively. There weren’t any symptoms for C5 nerve root palsy which is a common postoperative complication. Conclusions: The cervical posterior laminectomy, which includes en-bloc laminectomy and preserving of the facet joint capsule, allows a sufficient and safe decompression of the neural structures for cervical spondylotic myelopathy.
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    Transforaminal epidural steroid injection for recurrent lumbar disc herniation
    (2020) Yuce, Ismail; Kahyaoglu, Okan; Ataseven, Muzeyyen; Cavusoglu, Halit; Aydin, Yunus
    Aim: Transforaminal epidural steroid injection reduces the low back-leg pain which caused by lumbar disc herniation (LDH). The aim of our study is to evaluate the treatment of transforaminal epidural steroid injection for recurrent LDH. Materials and Methods: 19 patients were included in our study who were treated by transforaminal epidural steroid injection for recurrent LDH in our clinic between 2014 and 2018. We evaluated the patients pre-procedure and at 2 weeks, 3 and 6 months after treatment by Visual Analogue Scale / Oswestry Disability Index (ODI) and followed up for surgical treatment after 6 months.Results: The mean low back and leg pain VAS was 4.2±0.6 before TFESI procedure and it was 1.9±0.3 after two weeks. İt was 2.1±0.3, 3.6±0.8 at 3 and 6 months after procedure respectively. The reduction of low back and leg pain mean VAS is statistically significant between before treatment and at 2 weeks and at 3 months after TFESI procedure respectively (p0.05). The mean ODI was 21.4±0.3 before TFESI procedure and it was 12.4±0.7 after two weeks. İt was 15.3±0.5 and 18.2±0.1 at 3 and 6 months after procedure respectively. The four of all patients were treated by microdiscectomy for recurrent LDH.Conclusion: The transforaminal epidural steroid injection is safely treatment for non-surgical treatment of recurrent LDH. Our study recommends that transforaminal epidural steroid injection should be considered before surgical intervention and this procedure may support to surgical indication of recurrent LDH.