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    Effects of Local Administration of Boric Acid on Posterolateral Spinal Fusion with Autogenous Bone Grafting in a Rodent Model
    (Humana Press Inc, 2015) Komurcu, Erkam; Ozyalvacli, Gulzade; Kaymaz, Burak; Golge, Umut Hatay; Goksel, Ferdi; Cevizci, Sibel; Adam, Gurhan
    Spinal fusion is among the most frequently applied spinal surgical procedures. The goal of the present study was to evaluate whether the local administration of boric acid (BA) improves spinal fusion in an experimental spinal fusion model in rats. Currently, there is no published data that evaluates the possible positive effects if the local administration of BA on posterolateral spinal fusion. Thirty-two rats were randomly divided into four independent groups: no material was added at the fusion area for group 1; an autogenous morselized corticocancellous bone graft was used for group 2; an autogenous morselized corticocancellous bone graft with boric acid (8.7 mg/kg) for group 3; and only boric acid was placed into the fusion area for group 4. The L4-L6 spinal segments were collected at week 6, and the assessments included radiography, manual palpation, and histomorphometry. A statistically significant difference was determined between the groups with regard to the mean histopathological scores (p=0.002), and a paired comparison was made with the Mann-Whitney U test to detect the group/groups from which the difference originated. It was determined that only the graft+BA practice increased the histopathological score significantly with regard to the control group (p=0.002). Whereas, there was no statistically significant difference between the groups in terms of the manual assessment of fusion and radiographic analysis (respectively p=0.328 and p=0.196). This preliminary study suggests that BA may clearly be useful as a therapeutic agent in spinal fusion. However, further research is required to show the most effective dosage of BA on spinal fusion, and should indicate whether BA effects spinal fusion in the human body.
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    Management of fracture and dislocation associated with vascular injuries
    (Anatolian Journal of Clinical Investigation, 2014) Kömürcü, Erkam; Özden, Raif; Kaymaz, Burak; Gölge, Umut Hatay; Göksel, Ferdi; Özcan, Sedat; Yener, Ali Ümit
    The purpose of this study is to identify the factors that affect mortality and morbidity and that contribute to disability in vascular injuries associated with fracture and dislocation. Ninety-seven patients with vascular injuries associated with orthopedic fracture and dislocation in the study by searching hospital files retrospectively.Sixtytwo and thirty-five patients were male and female, respectively. Mean age of the patients was 36.6±12.1 years. The time elapsed between injury and surgical intervention was 3.6±1.9 hours. Tibia, femur and humerus fractures were the most encountered injuries with MESS value of 6.2±2. 2. External fixation and internal fixation osteosynthesis were used in 76 and 12 patients respectively. Vascular injuries were localized most frequently in femoral artery, popliteal artery. Preoperative arteriography was performed in 22 patients. 41 patients had isolated arterial injuries, 54 patients both artery and vein injuries. Priority was given to vascular repair in 68 patients; orthopedic stabilization was performed before the vascular treatment only in 22 patients. Only 4 patients lost their life in the postoperative period. Vascular injuries associated with fracture and dislocation, are major pathologies that must be diagnosed without delay and repaired urgently. There are still disputed issues in the algorithm of the treatment of these injuries and prospective studies are needed with wide patient series. © 2014, Anatol J Clin Investig. All rights received.
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    Safety and feasibility of lumbar spine for intralaminar screw fixation : a computed tomography-based morphometric study
    (2015) Kömürcü, Erkam; Kaymaz, Burak; Adam, Gürhan; Gölge, Umut Hatay; Göksel, Ferdi; Özden, Raif
    Objective: The use of intralaminar screws (ILS) in spinal surgery has experienced a recent increase in popularity. The aim of this study is to define the morphological parameters of the lumbar laminas so that guidance may be defined for ILS placement.Methods: The study involved the evaluation of lumbar computed tomography (CT) images of patients. Two hundred thirty-five patients (127 male, 108 female) were included in the study. The mean patient age was 44.2 years (19-78 years). The measured parameters of the lamina were the transverse inner diameter, transverse outer diameter (lamina width), lamina length, subdural space (safe zone), and spinolaminar angle for each lumbar level (L1-L5).Results: The mean transverse outer diameter (L1-L5) ranged from 7.2-7.8 mm, and mean transverse inner diameter ranged from 2.5-3.0 mm. The lamina of L3 had the largest width and the lamina of L1 and L5 the smallest. The mean lamina length was 26.6 mm, ranging from 21.0-34.0 mm, and the mean spinolaminar angle was 124.7°, ranging from 111-135°. The L1 level had the shortest mean lamina length and L4 the lowest spinolaminar angle. Mean subdural space (safe zone), which was narrowest at the L5 level, was 2.4 mm, ranging from 1.3-3.6 mm.Conclusion: ILS of the appropriate size (3.5-4.5 mm) and length (20 and 25 mm) can be used safely in the lumbar spine. However, further biomechanical studies should be performed to measure strength of the fixation
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    Safety and feasibility of lumbar spine for intralaminar screw fixation: a computed tomography-based morphometric study
    (Turkish Assoc Orthopaedics Traumatology, 2015) Komurcu, Erkam; Kaymaz, Burak; Adam, Gurhan; Golge, Umut Hatay; Goksel, Ferdi; Ozden, Raif
    Objective: The use of intralaminar screws (ILS) in spinal surgery has experienced a recent increase in popularity. The aim of this study is to define the morphological parameters of the lumbar laminas so that guidance may be defined for ILS placement. Methods: The study involved the evaluation of lumbar computed tomography (CT) images of patients. Two hundred thirty-five patients (127 male, 108 female) were included in the study. The mean patient age was 44.2 years (19-78 years). The measured parameters of the lamina were the transverse inner diameter, transverse outer diameter (lamina width), lamina length, subdural space (safe zone), and spinolaminar angle for each lumbar level (L1-L5). Results: The mean transverse outer diameter (L1-L5) ranged from 7.2-7.8 mm, and mean transverse inner diameter ranged from 2.5-3.0 mm. The lamina of L3 had the largest width and the lamina of L1 and L5 the smallest. The mean lamina length was 26.6 mm, ranging from 21.0-34.0 mm, and the mean spinolaminar angle was 124.7 degrees, ranging from 111-135 degrees. The L1 level had the shortest mean lamina length and L4 the lowest spinolaminar angle. Mean subdural space (safe zone), which was narrowest at the L5 level, was 2.4 mm, ranging from 1.3-3.6 mm. Conclusion: ILS of the appropriate size (3.5-4.5 mm) and length (20 and 25 mm) can be used safely in the lumbar spine. However, further biomechanical studies should be performed to measure strength of the fixation.