Person: GÜVENÇ, YAHYA
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GÜVENÇ
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YAHYA
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Publication Open Access Evaluation of clinical and radiological outcomes in degenerative lumbar spine disorders treated with peek rod(2023-10-01) KARAGÖZ, AHMET; GÜVENÇ, YAHYA; Günerhan G., Gürpinar I., Çaǧil E., Karadeniz R., Karaman A., Karagöz A., GÜVENÇ Y., Dalgiç A.Objective: This study aimed to evaluate the clinical and radiological outcomes of patients undergoing transpedicular screw and polyetheretherketone (PEEK) rod stabilization for the surgical treatment of degenerative diseases of the lumbar spine. Materials and Methods: A retrospective analysis was conducted on 51 patients diagnosed with degenerative spine disease, such as recurrent disc herniation, spinal stenosis, spondylolisthesis, and adjacent segment disease, who underwent bilateral transpedicular screw-PEEK rod stabilization between May 2017 and November 2020. Preoperative and postoperative assessments included lumbar lordosis angles, sacral slope, pelvic incidence, pelvic tilt, visual analog scale (VAS) scores, PROLO economic and social scores, and the presence of adjacent segments and fusion. Results: The study included 51 patients with a mean age of 62.5 years (range: 18-85 years), with 56.8% (29 patients) being female and 43.2% (22 patients) being male. Surgical procedures involved single-level stabilization in 16 patients, two-level stabilization in 21 patients, three-level stabilization in 9 patients, and four-level stabilization in 5 patients. The mean follow-up period was 52.4 months. Postoperatively, there was a significant reduction in VAS scores from a mean of 8.2±1.3 to 3.4±1.7 (p≤0.01). No significant changes were observed in the lumbar lordosis angle, sacral slope, pelvic tilt angle, and pelvic incidence angle. The mean PROLO score improved from 3.5±1.2 preoperatively to 7.6±1.5 postoperatively. Fusion was observed in 43 patients during the follow-up period. Conclusion: The use of PEEK rods in the surgical treatment of degenerative lumbar spine diseases may lead to improved postoperative quality of life and reduced implant-related complications. Furthermore, our findings suggest that patients without sagittal balance impairment may benefit from PEEK rod stabilization without significant changes in spinal alignment. However, further comparative and long-term studies are required to better understand the efficacy and outcomes of PEEK rod systems in this treatment approach.Publication Open Access Introduction to the nervous system from tissue engineering perspective(Elsevier, 2023-01-01) GÜVENÇ, YAHYA; KIVRAK, CAN; GÜVENÇ Y., KIVRAK C.; Gündüz, Oğuzhan; Üstündağ, Cem Bülent; Şengör, MustafaThere are no currently medical interventions that can directly repair and restore the neural structure and function in the brain and spinal cord. The biggest problem with neurological injuries is that we have no tools or skills to reconstruct and repair the neural tissue itself. The complexity of neuroanatomical pathways and networks makes this even more difficult, and at the same time, cellular low neuroregenerative capacity causes loss of nerve function. Although stem cell–based studies are effective in damaged nerve regeneration, limited integration with neural tissue, cell transplantation difficulties, and short-term cell survival after transplantation are the limitations of these studies. The development of 3d scaffolds, which contain progenitor cells, created by neural tissue engineering creates a support function for cells and is one of the steps developed to overcome these problems. In this way, neural tissue integration is facilitated and the necessary physical support for the neural tissue is provided. As can be understood from this, neuronal regeneration can be made possible by remodeling at the cellular or subcellular levels.Publication Open Access Comparison of the effectiveness of anesthesia methods on percutaneous kyphoplasty: Erector spinae plane block versus local anesthesia(2022-06-01) ORHON ERGÜN, MELİHA; GÜVENÇ, YAHYA; ORHON ERGÜN M., GÜVENÇ Y.ntroduction: Currently, local or general anesthesia is commonly applied in patients undergoing percutaneous kyphoplasty (PKP) procedures; however, the best anesthesia method for PKP remains elusive. This study examined the efficacy of erector spinae plane block (ESPB) in comparison with local anesthesia in terms of postoperative analgesia requirement and pain scores, in patients undergoing kyphoplasty. Methods: The files of 42 patients who underwent kyphoplasty were retrospectively reviewed. PKP procedure was either under local anesthesia (controls, n=20) or using ultrasound-guided ESPB (ESPB group, n=22). Postoperative analgesia requirement and pain scores assessed by visual analog scale (VAS) were recorded and compared. Result: All control patients (100.0%) required postoperative analgesia, whereas only five patients (22.7%) in the ESPB group required postoperative analgesia (p<0.001). At all time-points, ESPB group had significantly lower VAS scores (p<0.001 for 0, 2, and 6 hours). At two hours, all patients in the ESPB group had 0 VAS score. Conclusion: ESPB as a sole anesthesia technique for kyphoplasty procedures is a promising method that may reduce the need for perioperative analgesia and provide superior postoperative pain management, thus allowing pain-free discharge.Publication Open Access Cervical radiculopathy and spinal cord indentation caused by vertebral artery loop(2022-03-01) HARMAN, FERHAT; ALTUNTAŞ, DOĞUKAN; GÜVENÇ, YAHYA; KURŞUN, MELTEM; Bıyıklı E., Kurşun M., Güvenç Y., Harman F., Altuntaş D.Cervical radiculopathy and spinal cord indentation caused by vertebral artery loop formation is a rare entity. We report here an 85-year-old woman had a four-year history of neck pain and left arm weakness. Radiologic evaluation showed vertebral artery loop formation compressing the adjacent nerve root and spinal cord. Accurate radiologic diagnosis of this condition is crucial to reduce unexpected surgical complications.Publication Open Access Effects of pirfenidone on experimental head injury in rats(2022-01-01) GÜVENÇ, YAHYA; Bozkurt I., Ozturk Y., GÜNEY G., Arslan B., GÜLBAHAR Ö., GÜVENÇ Y., Senturk S., YAMAN M. E.Traumatic brain injury (TBI) continues to be a significant public healthcare concern. Neuroinflammation that occurs in the secondary phase of TBI leads to cognitive and physical dysfunction. A number of therapeutic modalities have been evaluated in an attempt to find a suitable treatment. The only drug approved for the treatment of idiopathic pulmonary fibrosis, pirfenidone, has been evaluated for its antifibrotic, anti-inflammatory, and anti-oxidant properties for various disorders, but this is the first study to examine its effects in an experimental TBI model. Twenty-four Wistar rats were randomly divided into three groups: control, trauma, and pirfenidone. The two latter groups underwent experimental diffuse cortical injury mimicking TBI. Neurological assessment was performed using the Garcia test, histological analysis was performed to examine neuroprotective and anti-inflammatory effects, and biochemical analyses of neuron-specific enolase (NSE), S-100B, caspase-3, and thiobarbituric acid reactive substances were performed. The pirfenidone group had a better Garcia test score (P=0.001), an increased anti-inflammatory effect (P<0.001), and an enhanced neuroprotective effect (P=0.007) along with decreased NSE, S100B, and TBARS levels compared to the trauma group. However, pirfenidone did not show a beneficial effect on caspase-3 levels. Pirfenidone may help decrease mortality and morbidity rates after TBI through its anti-inflammatory and antioxidant effects.Publication Open Access Effect of sumatriptan following simulated traumatic brain injury in rats(2022-01-01) GÜVENÇ, YAHYA; BOZKURT İ., ŞENTÜRK S., YAMAN M. E., GÜVENÇ Y., Öztürk Y., GÜNEY G., ÇİNGİRT M., GÜLBAHAR Ö.Introduction: Traumatic brain injury (TBI) continues to be a devastating problem in developing countries. The inevitable traumatic effect is followed by a secondary phase of neuroinflammation leading to increased morbidity and mortality. Numerous agents and treatment modalities have been tested to date. The first clinically available triptan used to treat migraine, sumatriptan (SUM), has been evaluated for cerebral, testicular and renal ischemia previously but to our knowledge this is the fi rst paper where its anti-inflammatory and anti-oxidative effects after experimental TBI in rats has been evaluated. Aim: Employing an experimental trauma technique, we aimed to investigate whether SUM has ameliorating effects on the infl ammatory phase of TBI via neurological, histological and biochemical analyses. Methodology: Twenty-three Wistar albino rats were randomly divided into three groups: control, trauma and trauma + SUM. The two latter groups underwent experimental diffuse cortical injury mimicking TBI. The subjects underwent neurological assessment via the Garcia Test, histological analysis via a novel scoring system and biochemical analyses of neuron specifi c enolase (NSE), S-100B, caspase-3 (CASP3), and rat thiobarbituric acid reactive substances (TBARS) levels. Results: SUM receiving group had a better Garcia Test score (P < 0.001), higher anti-inflammatory score (P = 0.004) and higher neuroprotective score (P < 0.001) along with a better histopathological score when compared with the trauma group. SUM receiving group had lower levels of S100B, CASP3 and TBARS. SUM was unable to reduce NSE levels. Conclusion: SUM may prove to be beneficial in decreasing mortality and morbidity rates after TBI through its anti-inflammatory and anti-oxidative effects. The novel scoring system used in this study may be a valuable tool for similar experiments.Publication Open Access Travmatik torakolomber kırıklı hastalarda intraoperatif nöromonitörizasyon sonuçlarının değerlendirilmesi(2022-10-13) HARMAN, FERHAT; GÜVENÇ, YAHYA; SÖNMEZ, ÖZCAN; YARALI, AHMET TUĞRUL; Harman F., Güvenç Y., Sönmez Ö., Yaralı A. T.Publication Open Access Evaluation of topical Dexmedetomidine administration in postlaminectomy epidural fibrosis rat model(ELSEVIER SCIENCE BV, 2018-05) GÜVENÇ, YAHYA; Yaman, M. E.; Ergul, G.; Guvenc, Y.; Ozturk, Y.; Erbay, F. K.; Tolunay, T.; Senturk, S.; Kircil, C.; Bozkurt, G.Epidural fibrosis is a challenging topic in spinal surgery. Numerous clinical and experimental studies have been focused on this issue to clarify problems faced in spinal procedures for the patient as well as the surgeon and find out new methodologies. Dense cytokines and growth factors which are released from inflammatory cells have been suggested to play a major role in the inception and progression of fibrosis. One of the most investigated and important actor in epidural fibrosis is assumed to be the transforming growth factor-1 beta (TGF-1 beta) formation. Studies showed that Dexmedetomidine (DEX) downregulates TGF-beta pathway with its anti-inflammatory and antioxidant effects. From this point of view, for the first time in the literature we try to observe if there will be an effect of topical DEX administration over epidural fibrosis in a rat model. We hypothesized that DEX might have preventive effects on epidural fibrosis via anti-inflammatory and antioxidant effects. Twenty-four adult male Wistar albino rats were randomly assigned to three groups (Topical DEX, Spongostan, Laminectomy). A total laminectomy was performed at the L3-L5 level and then the ligamentum flavum and epidural fat tissue were cleared away from the surgical site. Histopathological assessment was performed postoperatively after 4 weeks. Our study revealed that topical DEX administration may have effects on reducing epidural fibrosis. Topical DEX administration may be helpful in preventing epidural fibrosis after laminectomy in rats through multiple anti-inflammatory and antioxidant mechanisms as well as through TGF -1 beta pathway.