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    Comparison of sagittal lumbosacral parameters in patients with ankylosing spondylitis and chronic mechanical back pain
    (2019) Kocyigit, Burhan Fatih; Nacitarhan, Vedat; Koca, Tuba Tulay; Berk, Ejder
    Aim: Lumbosacral parameters can be affected in ankylosing spondylitis (AS) and chronic mechanical back pain.We compared lumbosacral parameters between patients with AS and chronic mechanical back pain to identify specific changes in AS. Material and Methods:This study has a retrospective design. A total of 42 patients with AS (16 females, 26 males) and 66 patients with chronic mechanical back pain (31 females, 35 males) were enrolled in the study. Lumbar lordosis angle (LLA), lumbosacral angle (LSA), sacral tilt (ST), and lumbosacral disc angle (LSDA) were measured using digitalized standing lateral lumbar radiographs. CRP and ESR concentrations of AS patients were obtained from the hospital database. Results: LLA, LSA, ST and LSDA were significantly smaller in the patients with AS (p < 0.05).CRP and ESR were significantly and negatively correlated with LLA and LSA (r = -0.516, p < 0.001; r = -0.401, p = 0.009 for CRP and r = -0.623, p < 0.001; r = -0.474, p = 0.002 for ESR). In AS patients, LLA was significantly and positively correlated with LSA and ST (r = 0.490, p = 0.001; r = 0.399, p = 0.009). Additionally, LSA was significantly and positively correlated with LSDA (r = 0.613, p < 0.001). Conclusion: The sagittal lumbosacral parameters of patients with AS were found to be significantly different from those of patients with chronic mechanical back pain. İnflammation negatively affects lumbosacral alignment in AS. The identification of specific changes in sagittal spinal alignment in patients with AS will contribute to the establishment of appropriate rehabilitation strategies and surgical plans
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    Evaluation of glenohumeral subluxation and related factors in patients with post-stroke shoulder pain
    (2020) Kocyigit, Burhan Fatih; Akaltun, Mazlum Serdar
    Aim: Glenohumeral subluxation (GHS) is a frequent complication of post-stroke patients which can be considered as a major predisposing factor for other disorders. We aimed to assess the frequency of GHS in patients with post-stroke shoulder pain and to determine the relationships of GHS with motor recovery, pain, functional status and depression. Material and Methods: This study has a descriptive design. A total of 73 stroke patients with shoulder pain were enrolled in this study. Patients’ demographic characteristics, disease duration, Brunnstrom motor recovery levels for upper extremities, functional ambulation scales (FAS), spasticity stages, pain levels, Barthel Index (BI) and depression scores were recorded. The presence of GHS was evaluated clinically and radiologically. Considering patients with and without GHS, clinical variables were compared.Results: Of the 73 patients, 21 (28.7%) of them had GHS. The ratio of patients in Brunnstrom Category I (Brunstrom 1-3) and non-functional ambulation level were significantly higher in patients with GHS (p 0.05). Shoulder flexion, abduction, internal rotation and external rotation ROMs were found to be significantly lower in patients with GHS (p 0.05). Pain levels and BDI scores were significantly higher, BI scores were significantly lower in patients with GHS, though (p 0.05).Conclusion: GHS is a frequent problem in stroke patients which is closely related to the motor recovery and ambulation level. Patients with GHS have a more restricted shoulder ROM, higher pain and depression scores and poor level functional independence.
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    Lumbosacral alignment in lumbar disc herniation
    (2019) Nacitarhan, Vedat; Kocyigit, Burhan Fatih; Berk, Ejder; Koca, Tuba Tulay
    Aim: Lumbosacral alignment has a potential role in providing proper spinal function, balanced and appropriate posture. The aim of our study was to compare lumbosacral angles between lumbar disc herniation and lumbar disc herniation-free patients. It was aimed to identify specific changes in lumbar disc herniation.Material and Methods: A total of 118 (69 female, 49 male) patients with the complaint of chronic low back pain were enrolled. Lumbar magnetic resonance images and standing lateral lumbar radiographs were obtained from the electronic hospital database. The presence or absence of disc herniation was diagnosed with lumbar magnetic resonance images. Measurement of lumbosacral angles were performed on the standing lateral lumbar radiographs.Results: Lumber lordosis angle and lumbosacral disc angle were significantly smaller in the lumbar disc herniation group (p = 0.033 and p = 0.038). No significant difference was detected in sacral tilt and lumbosacral angle (p = 0.705 and p = 0.413).Conclusion: The variations in lumbosacral angles cause changes in the spinal kinematics that may affect the occurrence of disc herniation. Loss of lumbar lordosis increases the compressive forces on the spine and may associate with the presence of disc herniation. Lumbosacral alignment must be taken into account when evaluate the pathophysiology of lumbar disc herniation.
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    The relationship between vitamin D level and disease activity and focal erosion in rheumatoid arthritis
    (2019) Kocyigit, Burhan Fatih; Akyol, Ahmet; Koca, Tuba Tulay
    Aim: Bone loss,fragility,and fractures are well-described complications that affect quality of life, morbidity, and health care costs during the course of rheumatoid arthritis (RA). Besides its well-known role in bone metabolism, vitamin D is also an important immune modulator, meant to affect the disease activity of rheumatic disorders. However, conflicting results have been demonstrated about the relationship between levels of vitamin D and disease activity in RA. Primary aim of was to compare vitamin D levels and Bone Mineral Density (BMD) values between RA and control groups.The secondary aim was to assess the correlations between vitamin D and disease activity and radiologic damage in RA.Material and Methods: A total of 41 RA patients and 40 healthy controls were included in this study. The patient and control groups were between the ages of 18 and 65. Disease activity score 28 (DAS-28) was used to determine the severity of disease.Sharp/van der Heijde method was performed to evaluate the radiologic changes.Dual energy X-ray absorptiometry (DEXA) was performed to measure Bone Mineral Density (BMD).Enzyme-Linked Immunosorbent Assay (ELISA) method was used to measure serum D vitamin concentrations.Results: Vitamin D levels, the BMD-lumbar spine, BMD-femur total and BMD-femur neck values were significantly lower in the patient group (p = 0.012, p 0.001, p 0.001 and p 0.05). DAS-28 was significantly and negatively correlated with BMD values (p 0.05).Conclusion: Our study suggests that RA patients have lower vitamin D levels, BMD-lumbar spine, BMD-femur total and BMD-femur neck values. Higher disease activity increases bone loss in RA. Vitamin D levels and BMD values should be monitored for the risk of osteoporosis and fracture in RA.Keywords: Rheumatoid Arthritis; Vitamin D; Bone Mineral Density; Disease Activity; Radiologic Damage.