Unilateral Dynamic Stabilization in Recurrent Lumbar Disc Herniation.

AIM: To evaluate the effectiveness and outcomes of unilateral dynamic stabilization in patients with recurrent lumbar disc herniation (RLDH). MATERIAL AND METHODS: Patients requiring an operation due to RLDH at the L4?5 level were included in the study.They divided into the following two groups: SD group who had only revision discectomy (n=20) and DD group who had unilateral dynamic rod stabilization with discectomy (n=20). Low back and leg pain were evaluated with the visual analog scale (VAS), and functional results were evaluated with the Oswestry disability index (ODI). The VAS scores were evaluated in two different regions as VAS Low Back (VASLB) and VAS Leg (VASL). The results of each patient were evaluated preoperatively and at 1 and 12 months postoperatively. The anterior disc height (ADH), posterior disc height (PDH), and segmental angle (SA) were measured on the sagittal computed tomography (CT) scans of each patient?s lumbar spine. Modified Pfirrmann grades in the operated and adjacent segments on lumbar magnetic resonance imaging (MRI) were assessed preoperatively and at 12 months postoperatively. RESULTS: A total of, 40 patients (17 women and 23 men; mean age, 47.9 years) were enrolled. There was no statistically significant difference in the VASLB scores between the two groups (p=0.42). The decrease in VASL scores was statistically significant between groups (p < 0.05). A statistically significant decrease in ODI scores was also observed (p < 0.05). When ADH and PDH obtained preoperatively and postoperatively were compared for the SD group, the differences were not statistically significant. Significant differences were found for ADH and PDH obtained preoperatively and postoperatively in the DD group (p < 0.05). However, for SA, the difference was not significant between the two groups (p=0.28). CONCLUSION: Unilateral dynamic stabilization for RLDH leads to fewer surgical complications and provides sufficient stability by preserving segmental movements.

Neuroprotective Effects of Milrinone on Acute Traumatic Brain Injury.

BACKGROUND: Traumatic brain injury is still an important health problem worldwide. Traumatic brain injury not only causes direct mechanical damage to the brain but also induces biochemical changes that lead to secondary nerve cell loss. In this study, we investigated the neuroprotective effect of milrinone after traumatic brain injury (TBI) in a rat model. METHODS: Forty male Wistar albino rats, were used. Rats were divided into 4 groups: 1) sham, 2) TBI, 3) TBI + Ringers, and 4) TBI + Milrinone. In group 1 (sham), only craniotomy was performed. In group 2 (TBI), TBI was performed after craniotomy. In group 3 (TBI + Ringer), TBI was performed after craniotomy and intraperitoneal Ringers solution was given immediately afterward. Group 4 (TBI + Milrinone), TBI was performed after craniotomy, and milrinone was given 1.0 mg/kg milrinone intraperitoneally directly (0.5 mg/kg milrinone intraperitoneally again 24 hours, 48 hours, and 72 hours after trauma). Tests were performed for neurological and neurobehavioral functions. Immunohistochemistry and histopathology studies were performed. RESULTS: In group 4 compared with group 2 and group 3 groups, tests for neurological functions and neurobehavioral functions were significantly better. In the milrinone treatment used in group 4, plasma and brain tissue tumor necrosis factor, 8-OH 2-deoxyguanosine , and interleukin 6 levels were significantly decreased, and increased plasma and tissue IL-10 levels were detected. Histopathological spinal cord injury and apoptotic index increased in groups 2 and 3, while significantly decreasing in group 4. CONCLUSIONS: This study shows for the first time that the anti-inflammatory, antioxidant and antiapoptotic properties of milrinone may be neuroprotective after TBI.