Yazar "Canaz, Hüseyin" seçeneğine göre listele

Listeleniyor 1 - 3 / 3
  • Küçük Resim
    Öğe
    Evaluation of neurological examination, sep results, mri results, and lesion levels in patients who had been operated for myelomeningocele
    (Wolters Kluwer Medknow Publications, 2020) Canaz, Gökhan; Canaz, Hüseyin; Tuna Erdoğan, Ezgi; Alataş, İbrahim; Emel, Erhan; Matur, Zeliha
    Objective: Myelomeningocele is the most severe and the most frequent form of spina bifida. Most of the myelomeningocele patients undergo operations in newborn age. In terms of life quality and rehabilitation, follow-up's of these patients in the growth and development period after the operation is critical. In our study, our aim is to emphasize the correlation of SEP results with MRI results and clinical features of the myelomeningocele patients. Materials and Methods: In our study, we included 36 patients who had undergone myelomeningocele operation and have been followed-up in Istanbul Bilim University Florence Nightingale Hospital, Spina Bifida Research and Treatment Centre. Posterior tibial nerve SEP was performed on each patient and neurological examinations were done in the same session. Results were compared with clinical functional lesion levels, levels of fusion defect and ambulation levels. In order to evaluate SEP results, we used age-related reference values from Boor et al.'s study in 2008. Patients were grouped as normal, unilaterally prolonged, bilaterally prolonged, unilaterally lost, and bilaterally lost. Results: The correlations of posterior tibial nerve SEP results were significant with ambulation levels (r = 0.428, P < 0.01), clinical functional lesion levels (r = 0.477, P < 0.01) and fusion defect levels (r = -0.528 P < 0.05). The lumbar SEP results were only significantly correlated with functional lesion levels (r = 0.443 P < 0.05). Conclusions: Radiological studies are insufficient when evaluating the functionality of the central nervous system. To fully evaluate the functionality and watch the neurological development with accuracy, especially in operated patients, electrophysiological studies should be an indispensable part of myelomeningocele follow-ups.
  • Küçük Resim
    Öğe
    The Results of Intraoperative Direct Electrical Stimulation of Roots and Placode During Myelomeningocele Repair
    (2018) Canaz, Hüseyin; Tuna Erdoğan, Ezgi; Alataş, İbrahim
    INTRODUCTION: The safety of transcranial high current stimulation is controversial in newborns. However, intraoperative direct stimulation techniques are safe and useful methods even for newborns to determine the functional neural tissue and to provide a safer surgery. We routinely use direct nerve stimulation techniques during myelomeningocele closure in our institution unless patient has total paraplegia. In this paper, we analyzed and presented the results of intraoperative direct stimulation of nerves and neural placode in 20 infants with myelomeningocele. METHODS: Intraoperative direct stimulation was performed and electromyography was followed from lower extremity muscles both for triggered and spontaneous activity during myelomeningocele repair. RESULTS: The compound muscle action potentials were correlated with motor examination of lower extremities. While, the level of conduction block in motor pathways involved nerve roots in some cases, most of the stimulated roots were functional which indicates the motor conduction block was upper in spinal cord. In one case dysmorphic appearing rootlet was found functional and preserved throughout the surgery. DISCUSSION and CONCLUSION: In our practice, intraoperative direct stimulation is a useful and reliable method to check the functional neural tissue and spare it to preserve during releasing and closure of neural tube in myelomeningocele operations.
  • Küçük Resim
    Öğe
    The Results of Untethering Procedures with Intraoperative Neuromonitoring: Occult Spinal Dysraphism and Tethered Spinal Cord Secondary to Myelomeningocele
    (2018) Canaz, Hüseyin; Tuna Erdoğan, Ezgi; Alataş, İbrahim
    Using intraoperative neuromonitoring in both primary and secondary tethered cord operations is accepted as a necessity for a safer operation and guiding surgeon in complex surgeries. METHODS: Twenty four operations which were monitored with three modalities; transcranial motor evoked potentials (TcMEP), free-run electromyography and direct nerve stimulations. In group 1, there were 14 patients underwent tethered cord operations due to occult spinal dysraphism, in group 2 there were 10 patients underwent tethered cord operations secondary to previous myelomeningocele repair. RESULTS: TcMEP responses of lower extremity were elicited in 92 % in group 1, 80 % in group 2. TcMEP responses of anal sphincter were elicited in 83 % in group 1, 60 % in group 2. No TcMEP change was observed during the surgeries in both group. Postoperative urodynamic results of both group were improved in 1 year period (78 % in group 1, 43 % in group 2). In patients with hypoactive bladder, we could not take anal sphincter responses in TcMEP. DISCUSSION and CONCLUSION: Untethering of spinal cord both in asymptomatic occult spinal dysraphism and TCS secondary to MMC, can improve impaired urodynamic results. Intraoperative neuromonitoring and direct stimulation provides information for a safer surgery and guide surgical maneuvers especially in secondary untethering. Intraoperative neurophysiological monitoring is beneficial for operations of MMC patients with neurological deficits, to preserve their residual motor functions. Since anal sphincter functions are correlated with bladder functions, it is possible to get no anal sphincter TcMEP response if patient has hypoactive bladder.