Person: GÜNDÜZ, OSMAN HAKAN
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GÜNDÜZ
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OSMAN HAKAN
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Publication Metadata only The relationships of motor-evoked potentials to hand dexterity, motor function, and spasticity in chronic stroke patients: a transcranial magnetic stimulation study(SPRINGER HEIDELBERG, 2016) AKYÜZ, GÜLSEREN DERYA; Cakar, Engin; Akyuz, Gulseren; Durmus, Oguz; Bayman, Levent; Yagci, Ilker; Karadag-Saygi, Evrim; Gunduz, Osman HakanThe standardization of patient evaluation and monitoring methods has a special importance in evaluating the effectiveness of therapeutic methods using drugs or rehabilitative techniques in stroke rehabilitation. The aim of this study was to investigate the relationships between clinical instruments and transcranial magnetic stimulation (TMS)-evoked neurophysiological parameters in stroke patients. This study included 22 chronic post-stroke patients who were clinically assessed using the Motricity Index (MI), finger-tapping test (FTT), Motor Activity Log (MAL) 28, Brunnstrom motor staging and Ashworth Scale (ASH). Motor-evoked potential (MEP) latency and amplitude, resting motor threshold (rMT) and central motor conduction time (CMCT) were measured with TMS. Shorter MEP-latency, shorter CMCT, higher motor-evoked potential amplitude, and diminished rMT exhibited significant correlations with clinical measures evaluating motor stage, dexterity, and daily life functionality. rMT exhibited a negative correlation with hand and lower extremity Brunnstrom stages (r = -0.64, r = -0.51, respectively), MI score (r = -0.48), FTT score (r = -0.69), and also with amount of use scale and quality of movement scale of MAL 28 scores (r = -0.61, r = -0.62, respectively). Higher MEP amplitude and diminished rMT showed positive correlations with reduced ASH score (r = -0.65, r = 0.44, respectively). The TMS-evoked neurophysiologic parameters including MEP latency, amplitude, rMT and CMCT generally have positive correlation with clinical measures which evaluate motor stage, dexterity and daily life functionality. Additionally, spasticity has also remarkable relationships with MEP amplitude and rMT. These results suggest that TMS-evoked neurophysiological parameters were useful measures for monitoring post-stroke patients.Publication Open Access Pain Relief due to Transsacrococcygeal Ganglion Impar Block in Chronic Coccygodynia: A Pilot Study(OXFORD UNIV PRESS, 2015-07) GÜNDÜZ, OSMAN HAKAN; Gunduz, Osman Hakan; Sencan, Savas; Kenis-Coskun, OzgeObjectiveCoccygodynia is a distressing condition that presents with pain around the coccyx. Impar (Walther) ganglion is a sympathetic ganglion located at the end of lumbosacral sympathetic chain. The objective of this study is to share our results and follow up of 34 ganglion impar blocks in 22 patients. DesignRetrospective pilot study. SettingInterventional Pain Clinic in the Department of Physical Medicine and Rehabilitation in a university hospital. SubjectsTwenty-two patients with coccygodynia who did not respond to conservative treatment and then presented to interventional pain clinic of a PM&R department in a university hospital MethodsPain was evaluated via 10-cm visual analog scale (VAS). VAS values were obtained before, 1 hour and 3 weeks after injection and during this study was conducted. ResultsFor achieving at least 50% relief of pain, the success rate of a first injection was 82%, but accounted for three technical failures. In patients with a successful outcome, relief lasted for a median duration of 6 months. Relief was reinstated for a median period of 17 months by a second injection in nine patients who presented for repeat treatment. No relief was achieved in two of these patients when they presented for a third treatment. ConclusionsGanglion impar block appears to be effective in patients who have coccygodynia resistant to conservative therapy, with high success rates and prolonged duration of effect. Controlled studies are required to reveal the mechanism of this effect.Publication Open Access Reply to the Letter by J. Hambraeus, 'Ganglion Impar Blocks for More than Coccygodynia'(OXFORD UNIV PRESS, 2016-03-15) GÜNDÜZ, OSMAN HAKAN; Gunduz, Osman Hakan; Sencan, Savas; Kenis-Coskun, OzgePublication Open Access Does obesity have an impact on the radiation exposure_x000D_ during lumbosacral transforaminal epidural steroid_x000D_ injections? Retrospective study(2019) GÜNDÜZ, OSMAN HAKAN; Savaş SENCAN;Esra GİRAY;Fırat ULUTATAR;Osman Hakan GÜNDÜZAim: To find out whether obesity or injection level have an impact on the amount of radiation exposure during fluoroscopy-guidedlumbosacral transforaminal epidural steroid injections (TFESIs).Material and Methods: Patients aged 19-65 years who underwent lumbosacral transforaminal epidural steroid injection wereretrospectively reviewed. Eighty-three patients with a mean age of 42.7±13.2 (19-65) years with signs and symptoms of unilaterallumbar radicular pain due to single level disc herniation were included. Subjects were categorized as normal weighted (18.5≤bodymass index (BMI) ≤ 24.9), overweighed (25≤BMI<30) and obese (BMI≥30) according to World Health Organization BMI criteria. Allpatients were given unilateral TFESIs, including39 (47%) L5, and 44 (53%) S1 level. Radiation exposure dose and procedure time wasautomatically measured by fluoroscope.Results: Radiation dosage increased significantly with increasing BMI (p=0.0001). No statistically significant differenceswere found when three groups’ procedure durations and NRS scores were compared (>0.05). The radiation dosages andprocedure durations between the two different injection levels (L5 and S1) were not found to be statistically significant (>0.05).Conclusion: Obesity is associated with increased radiation exposure independent of procedure duration and the injection level.Publication Metadata only Does facet tropism negatively affect the response to transforaminal epidural steroid injections? A prospective clinical study(SPRINGER, 2019) GÜNDÜZ, OSMAN HAKAN; Celenlioglu, Alp Eren; Sencan, Savas; Gunduz, Osman HakanObjectiveTo examine the impact of the presence of facet tropism on the results of transforaminal epidural steroid injection for unilateral radicular pain induced by lumbar disc herniation.Materials and MethodsWe included 112 patients diagnosed with unilateral, single-level lumbar disc herniation-induced radicular pain. Injection was planned at relevant levels. The patients were assessed using the Numerical Rating Scale, the Modified Oswestry Disability Index, and the Beck Depression Inventory before the injection and at hour 1, week 3, and month 3 after the injection. Presence of facet tropism was assessed by measuring the facet angles in the L3-4, L4-5, and L5-S1 segments of lumbar MRI T2 sequence axial section.ResultsA significant decrease in the Numerical Rating Scale and an increase in the Modified Oswestry Disability Index scores were detected at all follow-ups in groups comprising 39 patients with and 61 without facet tropism (p<0.05). On comparison, improvement in clinical parameters at week 3 and month 3 in the group without facet tropism was greater (p<0.05). As treatment success is considered to be a 50% reduction in the Numerical Rating Scale scores, 55.2% of the patients attained treatment success at month 3. Further, although the treatment success rate in the group with facet tropism was 34.2%, it was 69% in that without facet tropism (p<0.05).ConclusionFacet tropism correlates with less success of transforaminal epidural steroid injection; therefore, facet tropism may be a worthwhile measurement in a discussion with patients of the benefits of the procedure.Publication Metadata only Ganglion Impar block improves neuropathic pain in coccygodynia: A preliminary report(ELSEVIER URBAN & PARTNER SP Z O O, 2018) GÜNDÜZ, OSMAN HAKAN; Sencan, Savas; Kenis-Coskun, Ozge; Demir, Fatma Gul Ulku; Cuce, Isa; Ercalik, Tulay; Gunduz, Osman HakanAim of the study: To define the effectiveness of ganglion Impar block in improving neuropathic pain. Materials and methods: Patients who had pain around the coccyx for more than three months and did not respond to conservative treatment were included in this study. All the patients underwent fluoroscopy guided transsacrococcygeal ganglion Impar block with injecting 3 mL of 0.5% bupivacaine, 2 mL saline, and 1 mL (40 mg) of methylprednisolone. Patients were evaluated with visual analog scale (VAS) for pain, Leeds assessment of neuropathic symptoms and signs scale (LANSS) for neuropathic pain, Beck depression Inventory (BDI) for mood and Short-form 12 (SF-12) for quality of life before, 1 month 3 months and 6 months after the injection. Patients' painless sitting duration was also recorded. Results: A total of 28 patients were included in the final analyses. VAS and LANSS scores improved significantly throughout the follow-up periods. BDI scores also improved while SF-12 scores did not show significant changes. Painless sitting period of the patients' improved significantly. Conclusions: Ganglion Impar block is effective in decreasing the neuropathic component of chronic coccygodynia. This improves painless sitting in patients but its reflections on quality of life is not clear. (C) 2018 Polish Neurological Society. Published by Elsevier Sp. z o.o. All rights reserved.Publication Metadata only Complex Regional Pain Syndrome(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2011) GÜNDÜZ, OSMAN HAKAN; Kishner, Stephen; Rothaermel, Brett J.; Munshi, Satvik B.; Malalis, Jacinthe V.; Gunduz, Osman HakanComplex regional pain syndrome (CPRS) is a neuropathic pain disorder that can develop as a result of trauma, surgery or nerve injury, but many times no precipitating event is known. The pain is described as severe, constant, burning and/or deep aching. The hallmark of CRPS is pain and mobility problems disproportionate to the initial injury. Clinical features can include spontaneous limb pain, changes in skin color and temperature, swelling, vasomotor instability and autonomic dysfunction. The pathophysiology is not well understood, although progress is being made in better understanding the underlying mechanisms. The diagnosis of CRPS is generally clinical, but there are tests and procedures that may help support the diagnosis. The general awareness of CRPS is poor, and well-accepted treatment guidelines are lacking. Treatment should involve an interdisciplinary approach involving functional rehabilitation, pain management, and psychological treatment. Quality evidence supports the use of some medications. Other adjuvant therapies and more invasive treatments exist for refractory cases. Turk J Phys Med Rehab 2011;57:156-64.Publication Metadata only A case of drop foot due to piriformis syndrome(2015) GÜNDÜZ, OSMAN HAKAN; Yıldırım, Pelin; Guler, Tuba; Misirlioglu, Tugce Ozekli; Ozer, Tulay; Gunduz, Osman HakanPublication Metadata only Outcome measurement in patients with low back pain undergoing epidural steroid injection(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2019) ŞANAL TOPRAK, CANAN; Ercalik, Tulay; Atalay, Kardelen Gencer; Toprak, Canan Sanal; Gunduz, Osman HakanObjectives: This study aims to evaluate the outcomes of epidural steroid injection (ESI) in patients with low back pain. Patients and methods: This prospective study included a total of 82 patients (51 females; 31 males; mean age 50.8 +/- 14.2 years; range, 17 to 86 years) who underwent ESI due to lumbar disc hernia-induced radiculopathy between September 2014 and May 2015. The Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), Istanbul Low Back Pain Disability Index (ILBPDI), and the Short Form-36 (SF-36) were administered to all patients before and three weeks and three months after ESI. Results: The mean scores of all scales were significantly lower at three weeks and three months following ESI compared to the baseline scores. There were no significant differences between the mean scores at three weeks and three months. The NRS yielded the highest post-ESI change from baseline. Conclusion: Our study results showed that all scales used in this study were effective tools for the evaluation of outcomes of EPI in patients with low back pain. Although the NRS yielded the highest sensitivity for detecting change, evaluating functional state and quality of life is essential for multivariate analyses.Publication Open Access Recovery of H-Reflex with Transforaminal Epidural Steroid Injection in S1 Radiculopathy(OXFORD UNIV PRESS, 2017-01-13) GÜNDÜZ, OSMAN HAKAN; Gunduz, Osman Hakan; Sencan, Savas; Ercalik, Tulay; Suhaimi, Anwar
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