Lumbar paragangliomas are rare neuroendocrine neoplasms arising from specialized neural crest cells in the cauda equina/filum terminale region. They are difficult to diagnose radiologically and can be difficult to treat surgically if they secrete catecholamines. A 38-year-old woman presented with three and a half years of increasing lower back and sacrum discomfort. Her neurological examination was normal. The MRI revealed an L4 intradural lesion that was compressing the cauda equina. A total tumor resection was conducted. The paraganglioma was diagnosed by the pathology report. Paragangliomas should be considered in the differential diagnosis of intradural masses of the lumbar spine.

Background and Objectives: The assessment of cervical lordosis is essential for surgical planning and outcome prediction in patients with cervical spine pathology. This study aims to evaluate the accuracy of cervical lordosis measurements obtained on supine CT and MRI relative to standing lateral radiographs. Materials and Methods: In this retrospective review, 108 patients who underwent standing lateral radiographs, supine CT, and MRI within a 30-day period were identified. C2–C7 Cobb angles were measured on each modality. Using upright radiographs as the reference standard, the predictive capability of both supine CT and supine MRI in classifying kyphotic versus non-kyphotic alignment was calculated. Results: Standing radiographs demonstrated significantly greater lordosis than supine imaging, with mean paired differences of 6.2° versus CT and 5.0° versus MRI (both p < 0.001); however, strong correlations were observed (with CT: r = 0.75; with MRI: r = 0.72; both p < 0.001). Further, CT-based measurements predicted X-ray Cobb angles with an R² value of 0.57 (estimated X-ray Cobb angle = 8.24 + 0.74 × (CT Cobb angle), β = 0.74, p < 0.001). MRI-based measurements yielded an R² of 0.51 (estimated X-ray Cobb angle = 7.59 + 0.71 × (MRI Cobb angle), β = 0.71, p < 0.001). At threshold ≥ 0°, CT achieved a 100% NPV for excluding kyphosis on upright radiographs. MRI achieved an NPV of 100% when the Cobb angle was >1.20°. Conclusions: Supine CT and MRI systematically underestimate cervical lordosis but demonstrate strong predictive correlation with standing radiographs and reliably exclude true kyphotic alignment, with each achieving near-perfect NPV at defined thresholds. In cases where standing radiographs are unavailable or nondiagnostic, supine imaging modalities such as CT and/or MRI, where the cervical region appears nonkyphotic, can safely rule out cervical kyphosis and inform surgical planning; however, in cases where the cervical region appears kyphotic on CT and/or MRI, standing radiographs remain essential for accurate assessment.

Dural grafts are sometimes necessary for repairing spinal dural defects. The search for an ideal material for duraplasty remains a controversial topic. Twenty-six adult male Wistar-Albino rats, weighing 260-380 g, were used. The rats were divided into three groups: Control (n=10), Fascia (n=6), and Gore-Tex (polytetrafluoroethylene) Surgical Membrane group (n=10). After laminectomy was performed on the rats, a dural defect was created. Then, one of the procedures 'leaving the defect open,' 'duraplasty with fascia,' and 'duraplasty with Gore-Tex surgical membrane' was performed. On the 60th day after surgery, the rats were euthanized, and histological investigations were conducted to examine the granulation tissue and adhesions in the operative area. It was observed that granulation tissue filled the defect area in all three groups. In the fascia group, it was observed that the fascia formed a barrier between the dura mater and neural tissue and the granulation tissue, but it was filled with dense granulation tissue and there was adhesion. It was found that the granulation tissue did not adhere to the Gore-Tex surgical membrane in the Gore-Tex surgical membrane group, and the Gore-Tex surgical membrane created an excellent physical barrier preventing adhesion between the dura mater and neural and the granulation tissues.

Aim: The annual incidence of chronic subdural hematoma is 2-4/100000 in geriatric population. We aimed to investigate relationship between potentially inappropriate medication usage according to Beers 2019 criteria, fall and Charlson comorbidity index in geriatric patients diagnosed with chronic subdural hematoma. Materials and Methods: We retrospectively collected medical records of 69 geriatric patients diagnosed with chronic subdural hematoma and hospitalized for the last 5 years in neurosurgery department of Izmir Katip Çelebi University Hospital with the permission of local ethical committee of medical faculty. Data was recorded and analyzed with appropriate method by using SPSS v18. Results: Mean age was 78.43 ± 7.51 years, mean Charlson comorbidity index was 5.87 ± 2.97. Falling events were responsible for 59 (85.5%) out of 69 chronic subdural hematoma cases. Potentially inappropriate medication usage according to Beers 2019 criteria was found in 20 (29%) patients. Inappropriate medications belonged to cardiovascular system (14.5%) class and antiplatelet/anticoagulant (14.5%) class mostly. When group was divided into two groups as patients who used potentially inappropriate medication or not, Charlson comorbidity index was found to be higher in the first group. (p 0.05). Charlson comorbidity index and number of medications showed significant correlation (p = 0.001). Conclusion: We could not reach a significant correlation between fall, Charlson comorbidity index and potentially inappropriate medication usage in our retrospective study. Small study population size, unreliable medical records and relatively healthy characteristics of population may contribute to crossing results.

Background: Unplanned hospital readmission after surgical treatment of primary spinal infections (PSIs) represents a major clinical and economic burden. Despite the fact that advances in surgical and antimicrobial management have been made, risk stratification for early and late readmissions remains poorly defined. Objective: We aimed to explore the clinical, microbiological, and perioperative characteristics potentially associated with 30-day, 90-day, and 1-year unplanned readmissions following the surgical treatment of PSIs in adult patients. Methods: A retrospective cohort study was performed that included adult patients who underwent surgery for primary spinal infections between January 2017 and December 2023 at our tertiary referral center. Demographics, comorbidities, laboratory parameters, microbiological profiles, and postoperative outcomes were analyzed. Associations between candidate variables and readmission were explored using univariate statistical analyses; multivariable modeling was not performed due to the low number of readmission events. Results: In total, seventy-nine patients (mean age 62.2 ± 12.7 years; 38% female) were included. The in-hospital mortality rate was 5.1%; at 1-year follow-up, 10.3% of patients were readmitted and 5.9% required reoperation; and Staphylococcus aureus was the most common isolated pathogen. No independent variables demonstrated a statistically significant association with readmission. However, trends toward higher readmission were observed in patients with liver disease, hypoalbuminemia, and postoperative transfusion. Conclusions: In this exploratory single-center cohort, the low number of readmission events limited statistical power and precluded adjusted modeling. Univariate analyses did not identify statistically significant associations between the evaluated variables and 30-day, 90-day, or 1-year readmission; therefore, the results should be interpreted cautiously as hypothesis-generating. Larger prospective multicenter studies with adequate event counts are needed to support adjusted risk stratification approaches. Until such tools are available, close postoperative follow-up across all PSI patients is necessary.

Klippel-Feil Sendromu ile ilişkili çok seviyeli konjenital servikal füzyonları olan 51 yaşındaki erkek hastada, C3-C4 ve C4-C5 seviyelerinde saptanan spinal kord basısı ve miyelomalazi tedavi edilmiştir. C2 ve T1 seviyelerine intralaminar vidalar, diğer seviyelere ise lateral mass vidaları yerleştirilerek kombine bir posterior stabilizasyon ve ardından geniş kapsamlı bir dekompresyon cerrahisi uygulanmıştır. Vaka, anatomik varyasyonlar nedeniyle cerrahın farklı stabilizasyon tekniklerine hakim olmasının önemini ve dekompresyona ek olarak stabilizasyonun gerekliliğini vurgulamaktadır. A 51-year-old male patient with Klippel-Feil Syndrome, presenting with multi-level congenital cervical fusions, was treated for spinal cord compression and myelomalacia at the C3-C4 and C4-C5 levels. The surgical procedure involved a combined posterior stabilization using intralaminar screws at C2 and T1 and lateral mass screws at other levels, followed by extensive decompression. This case highlights the necessity of combining stabilization with decompression and underscores the importance of a surgeon's familiarity with diverse fixation techniques when dealing with complex anatomical variations.