The management of orthopedic trauma surgery during the COVID-19 pandemic in Turkey.

COVID-19 has now alarmed the whole world, putting many countries' health systems in trouble. We aimed to evaluate the affect of the new treatment strategy that shortens hospital stay in orthopedic trauma patients in pandemic.Trauma patients who underwent surgical treatment between March 15th-May 1st 2019 and 2020 were examined about time interval from admission to surgery, period from surgery to discharge and total hospital stay time. This cohort was compared to a retrospective cohort of patients admitted for the same reasons in the same period of the previous year. During COVID pandemia, 51 trauma patients operated with the mean period from admission to operation 1.45 days, faster than the previous year's same period (3.76 days). From operation day to discharge time was 1.6 days in pandemic period and 4.3 days last year. The total hospitalization period (3,05 days) was significantly shorter in pandemic than the same period of the last year (8,06 days). (p<0.05). No complications and mortality were observed in any of our patients with faster trauma treatment strategy in pandemic. The operation of orthopedic trauma patients requiring surgery during a pandemic in a shorter time than normal time will not increase the complication and mortality, but will also help to use the bed more effectively by reducing the hospital stay.

A new approach for spinal deformity patients with meningomyelocele: reverse Y incision.

We report a new surgical incision for spinal deformity in patients who had undergone meningomyelocele closure surgery. Six patients underwent kifectomy using an inverse Y incision. They all had multiple prior operations in the lumbar region due to dural meningomyeloceles. Four of the patients were girls. The primary indication for the reverse Y incision was a T12 and above posterior fusion defect and a large lumbar posterior fusion defect. These patients included four with kyphoscoliosis, one with lordoscoliosis, and one with lumbar kyphosis. The median age of the patients was 5.52 at the time of operation. The median follow up time was 17.3 months. Under appropriate indication, the reverse Y approach offers a reliable and successful solution for surgery.

Transforaminal Lumbar Interbody Fusion For Lumbar Degenerative Disease: Patient Selection And Perspectives.

Most adults will experience low back pain during their lifetime, with most of these instances resolving or improving without sequelae in a few weeks. For the small number of patients with severe, recalcitrant pain, lumbar fusion may be required, particularly when concomitant leg pain or deformity is present. Lumbar interbody fusion surgery is the usual treatment for degenerative lumbar disease, but it requires a long recovery period. Many surgical techniques have been described in the literature for spondylolisthesis. The main objective is to create interbody fusion, decompression of normal structures and a stable vertebrae. TLIF surgical techniques has a long learning curve. Comorbidities of the patient may make surgery more difficult. Methods such as transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion, anterior lumbar interbody fusion and lateral lumbar interbody fusion are also available for interbody fusion in the literatüre. The aim of this review is to show which patients are more suitable for TLIF surgery and to discuss the advantages and disadvantages of TLIF surgery over other techniques.