Publications by authors named "Suna Dilbaz"

2 Publications

  • Page 1 of 1

Transverse Process Fractures: A Clinical Series and Coronal Injury of the Spine.

World Neurosurg 2018 Nov 28. Epub 2018 Nov 28.

Neurosurgery Department, Gazi Hospital, Izmir, Turkey.

Background: Transverse process fractures in trauma patients frequently are diagnosed using computed tomography and result in severe pain and limitation of motion. However, there is no accepted standard of care. Thus, these fractures can be treated with excessive measures or inadequately treated. In this study, diagnosis and treatment of transverse process fractures are examined.

Methods: The mechanisms of trauma, findings, and associated organ injuries of 50 patients with transverse process fractures and no other spinal injuries treated between 2013 and 2015 were recorded. The same treatment protocol was applied to each patient. The results of the treatments were examined retrospectively and recorded.

Results: Deformation and edema of the fascia and muscles around the transverse process fractures were detected by computed tomography and magnetic resonance imaging. The average pain intensity of the patients before treatment was 8.8 of 10 on a visual analog scale and 5.2 of 10 after treatment with nonsteroidal anti-inflammatory drugs, muscle relaxants, flexible support corsets, and mobilization. Patients hospitalized for additional pathologies were primarily treated in thoracic surgery wards (11 of 15 patients). Transverse process fractures were caused by backward falls or blows to the back in 49 patients.

Conclusions: Transverse process fractures can be treated quickly and effectively with the recommended protocol after excluding any accompanying organ injuries or other spinal injuries. Transverse process fractures most often occur during backward falls or blows to the back, commonly low-energy injuries. This trauma mechanism can be described as a "coronal injury of the spine."
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November 2018

Spinal cord compression caused by a brown tumor at the cervicothoracic junction.

Spine J 2007 Nov-Dec;7(6):728-32. Epub 2007 Feb 12.

Clinic of Neurosurgery, Sişli Etfal Education and Research Hospital, 80220, Istanbul, Turkey.

Background Context: Brown tumors are classic benign skeletal manifestations of hyperparathyroidism, but the spine involvement is very rare. Spinal reconstruction in these patients is controversial because of the severe osteoporosis and impaired bone healing. Of the reported 12 cases of spinal brown tumors in the literature, only in 5 were reconstructions with bone graft used.

Purpose: To describe our management in a patient with brown tumor and also to review the previous published cases.

Study Design: Case report.

Methods: A case of a brown tumor in the T1 vertebra of a 72-year-old male patient is described. He had a previous diagnosis of secondary hyperthyroidism caused by renal failure. First, posterior transpedicular open biopsy was performed for the diagnosis and also for the decompression of the root causing brachialgia. After the diagnosis of a brown tumor, the patient was reoperated through anterior approach for total tumor removal and reconstruction of the spine. An autolog 3-cortical iliac crest strut graft was used for fusion, and medical treatment of hyperparathyroidism was given immediately after the operation. Decompression of spinal canal and fusion of bone graft was shown by a computed tomography scan 1 year after the operation.

Results: Complete resolution of the complaints of the patient and fusion of the graft were achieved.

Conclusion: The determination of a spinal tumor in a patient with renal failure and hyperparathyroidism should bring to mind the probability of a brown tumor. Although it is of a benign nature, it can cause severe neurologic deficit because of spinal compression. The recommended treatment modality is surgical resection of the tumor, spinal reconstruction, and aggressive treatment of hyperparathyroidism both with parathyroidectomy and medically.
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February 2008