Surgery for far lateral lumbar disc herniation (FLLDH) hernias is different than surgery for median and paramedian disc hernias. Our study offers a minimally invasive surgical technic for far lateral disc herniations. The results of the midline surgical approach in 18 patients diagnosed with FLLDH were evaluated retrospectively. A total of 18 patients (7 females, 11 males), with a mean age of 57.9±9.4 years (range: 35-71 years), were included in the analyses. Three patients (16.7%) had lesions at the left L3-L4 level, six patients (33.3%) on the left L4-L5 level, five patients (27.8%) on the right L3-L4 level, and four patients (22.2%) on the right L4-L5 level. All patients had low back and leg pain. These complaints completely regressed after surgery. This study presents a review of a consecutive series of patients who underwent minimally invasive surgery for FLLDH using a midline approach.

Background/aim: To investigate the histopathological effects of reabsorbable polyethylene glycol hydrogel (RPGH, Coseal) on epidural fibrosis (EF) following laminectomy in rats. Materials and methods: A total of 24 rats were equally divided into three groups. In the first group, no treatment was applied after laminectomy (control group, Group 1). In the second group, hemostasis was achieved after laminectomy, and 2 mm absorbable gelatin sponge soaked in saline was placed over the epidural space and the wound was closed (Group 2). In the third group, hemostasis was achieved following laminectomy, and 0.5 mL RPGH (Coseal, Group 3) was squeezed over the dura mater, and the wound was closed. A histopathological examination was undertaken to evaluate arachnoidal invasion and EF. Results: The results of EF in the Group 2 and Group 3 were significantly lower compared to the Group 1 (p = 0.023 and p = 0.002, respectively). No statistically significant difference was found between the Group 2 and Group 3 in terms of EF (p = 0.957). There was also no statistically significant difference between the mean arachnoidal invasion of the three groups (p > 0.171). However, the rate of arachnoidal invasion was the lowest in the Group 3. Conclusion: Intraoperative Coseal, a polyethylene glycol polymer, tends to reduce the risk of epidural fibrosis, although this is not statistically significant.

To investigate the histopathological effects of a peripheral benzodiazepine receptor agonist (Ro5-4864) on epidural fibrosis (EF) in an experimental study model (post-laminectomy) in rats.A total o...

Objectives: To evaluate the effect of berberine (BBR) in preventing the development of epidural fibrosis (EF) after lumbar surgery in rats. Methods: This experimental study was carried out at the animal laboratory of Zonguldak Bülent Ecevit University, Zonguldak, Trurkey, between April 2020 and June 2020. A total of 32 Wistar albino female rats underwent laminectomy and were divided into 4 equal groups. Group 1 did not receive any treatment (control group). In group 2, absorbable gelatin sponge was placed at the surgical site. Groups 3 was administered BBR 10 mg/kg and group 4 was administered BBR 60 mg/kg per oral per day for one week after laminectomy. All rats were sacrificed 6 weeks after the operation. Concentration of hydroxyproline (HP) in tissues and histopathological evaluations were carried out to evaluate the level of fibrosis. Results: Epidural fibrosis results in group 4 were significantly lower than those in groups 1 and 2 (p≤0.001). However, there was no significant difference between the mean EF degree between group 2 and group 3. Arachnoidal invasion in both group 3 and group 4 were significantly lower compared to group 1 (p<0.05). In terms of HP results, the difference between group 4 and group 1 was statistically significant (p<0.001). Conclusion: This study provides preliminary evidence of the potential use of BBR for preventing the development of EF.

Extracranial metastases from primary brain tumours are mostly caused by high-grade tumours. Metastases from low-grade intracranial tumours are much rare and usually asymptomatic. We present a case of a symptomatic spinal cord compression with intradural extramedullary and diffuse leptomeningeal infiltration observed approximately 51 months after the first diag-nosis of a 52-year male patient with WHO Grade 2 oligodendroglioma with temporoparietal localisation. This patient, who had the complaint of weakness in the lower extremity, was operated on due to a thoracic intradural extramedullary mass. The result of the pathological examination came out as WHO Grade 2 oligodendroglioma, and radiotherapy was planned for this seeding metastasis. The patient who experienced refractory seizures died before his radiotherapy treatment was completed. It should be kept in mind that spinal metastases may also be seen in low-grade intracranial tumours without malignant transformation as in the present case.

Objective: To investigate the effectiveness of topical tranexamic acid (TXA) use on bleeding and drain withdrawal time in adult patients undergoing thoracolumbar fusion surgery. Study Design: Cross-sectional comparative study. Place and Duration of Study: Zonguldak Bulent Ecevit University Hospital, Zonguldak, Turkey, from January 2019 to August 2020. Methodology: The data of patients, who received thoracic and/or lumbar fusion surgery, were evaluated. The patients were divided into two groups as Group A (30 patients) in which 1 g topical TXA was applied to the surgical site at the end of the surgery; and Group B (30 patients) who did not receive this medication. Results: The body mass index (BMI) and the patients' demographic factors were similar in both the groups. There were no statistically significant differences between the two groups in terms of the surgical time and level, perioperative ES and FFP transfusion rates (p >0.05). While the amount of perioperative bleeding was almost the same (650 mL, p = 0.778), the amount of postoperative bleeding was lower in Group A (138.1 +/- 55.6 mL) in comparison to Group B (230.3 +/- 65.4 mL). Postoperative ES transfusion was performed on two patients in Group A (6.7%) and six patients in Group B (30%) (p = 0.02). Accordingly, the mean drain withdrawal time in Group A was 3 (2.8-3.0); days, and in Group B, this time was 6 (5.0-6.0) days (p <0.001). Systemic side effects, especially thromboembolism, were not observed in any of the patients. Conclusion: The topical use of TXA in spinal fusion surgery reduced perioperative blood loss.