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Yayın Comparison of Local Steroid Injection and Pulsed Radiofrequency Neuromodulation for the Treatment of Mild Idiopathic Carpal Tunnel Syndrome(JOURNAL NEUROLOGICAL SCIENCES, 2016) Suslu, Husnu; Turan Suslu, Hikmet; Guclu, Bulent; Ozdogan, Selcuk; Duzkalir, Ali Haluk; Karabagli, HakanAim: The aim of this study was to compare the effectiveness of local steroid injection and pulsed radiofrequency neuromodulation for the treatment of mild idiopathic carpal tunnel syndrome. Methods: Fifty-nine patients investigated retrospectively. The results of local steroid injection for the treatment of idiopathic carpal tunnel syndrome in 28 patients were compared with pulsed radiofrequency neuromodulation in 31 patients. The visual analogue scale and neuropathic pain scale scores were evaluated before and 1, 3 and 6 months after treatment in both groups. Results: Following the procedure, each patient reported an absence of pain, disappearance or reduction of paraesthesia and improvement in hand function. At 1, 3 and 6 months after the procedure, there was significant improvement in visual analog scale and neuropathic pain scale scores compared to the preprocedure states in both groups. The improvement rates of preprocedure and postprocedure visual analog scale scores and neuropathic pain scale scores were similar for both groups except postprocedure sixth month scores. There was a statistically significant difference in neuropathic pain scale scores at postoperative sixth month between the local steroid injection and pulsed radiofrequency neuromodulation groups so that local steroid injection reported more effective. Conclusion: Local steroid injection gives better long-term results than pulsed radiofrequency neuromodulation for the treatment of idiopathic carpal tunnel syndrome.Yayın Comparison of the Effects of Local and Systemic Dexamethasone on the Rat Traumatic Sciatic Nerve Model(TURKISH NEUROSURGICAL SOC, 2013) Suslu, Husnu; Altun, Murat; Erdivanli, Basar; Suslu, Hikmet TuranAIM: The aim of the study was to evaluate the effect of peroperatively locally administered dexamethasone on nerve recovery after induced nerve crush injury. MATERIAL and METHODS: 4 groups of 8 animals were formed. The sciatic nerves of 32 rats were exposed at midthigh level and those of 24 rats were crushed for 30 seconds with a pair of jeweler's forceps. RESULTS: Sciatic functional index (SFI) measurements of all the animals included at days 7, 14, 21 and 28 was statistically significant (p<0.05). Pinch tests that were done on the first 13 days gave negative results in all the groups. There was a difference between the test results of Group II and those of Group III and IV at days 14, 21 and 28. When the duration of the experiment was taken as a whole, no difference was observed between the test results of Group Ill and IV. CONCLUSION: Recovery in the group treated with local dexamethasone was more remarkable than that in the group treated with systemic dexamethasone in our study. As the difference was statistically significant, we recommend the perioperative use of local dexamethasone in procedures that might induce nerve injury.Yayın The effects of ozone oxidative preconditioning on subarachnoid hemorrhage via rat cerebral vasospasm model(Wolters Kluwer Medknow Publications, 2021) Süslü, Hikmet Turan; Tatarli, Necati; Ceylan, Davut; Suslu, Husnu; Bozkurt, Suheyla Uyar; Avsar, Timucin; Guclu, BülentObjective: Cerebral vasospasm after subarachnoid hemorrhage (SAH) is a major cause of morbidity and mortality. Inflammation is the major molecular mechanism observed in vasospastic SAH. Özone (O3) has been used as a therapeutic agent in the treatment of various conditions and diseases for years. The aim of this study was to evaluate the anti-inflammatory effect of ozone oxidative preconditioning (OOP) in a rat model of SAH in order to assess the therapeutic potential of O3 in SAH therapy. Materials and Methods: In the presented study, an experimental in vivo SAH rat model that provided constriction of large cerebral arteries was used. The inflammatory response of cerebral vasospasm after SAH and the effects of OOP were evaluated by comparing the mRNA levels of inflammatory molecules (tumor necrosis factor-alpha, interleukin-1 beta, and intercellular adhesion molecule-1) in the serum samples of rats. Results: The level of inflammatory molecules increased in vasospasm at 12 h, 24 h, and 48 h in the posttreatment groups. However, intraperitoneal OOP decreased the level of inflammatory molecules dramatically. Conclusions: Our study indicated that O3 treatment has potential in the management of inflammation created in a rat SAH model. These findings may inform further studies investigating possible uses of O3 in the treatment of vasospasm.Yayın Influence of Prior Lumbosacral Surgery on The Incidence of Intravascular Injection During Transforaminal Epidural Injections(JOURNAL NEUROLOGICAL SCIENCES, 2015) Suslu, Husnu; Suslu, Hikmet Turan; Tatarli, Necati; Ceylan, Davut; Guclu, Bulent; Karabagli, HakanObjective: Percutaneous lumbar transforaminal epidural steroid injections are frequently used to treat low back pain. However, many reports have indicated that this procedure has a high risk of morbidity. The aim of this study was to determine the difference in the incidence of vascular penetration during lumbosacral transforaminal epidural injections between patients with previous lumbar spinal surgery and patients who did not undergo surgery. Design: This is a prospective clinical study. Methods: In this study, patients who received lumbar transforaminal epidural injections at an outpatient spine center were included and followed. An interventional spine physician observed fluoroscopically guided lumbosacral transforaminal epidural steroid injections under live fluoroscopy and recorded contrast patterns. A total of 296 fluoroscopically guided lumbosacral transforaminal epidural steroid injections under live fluoroscopy in 108 patients were evaluated. Results: The incidence of vascular contrast patterns was observed under live fluoroscopy. Vascular injections were observed in 28 of the 296 injections, for an overall incidence of 9.5%. The incidence of intravascular injections among patients was 40.0% (20/50) in the previously operated group and 13.8% (8/58) in the non-operated group. This difference was statistically significant (p<0.001). A secondary analysis was performed to determine if the other factors affected the success of the procedure or increased the incidence of vascular injections. Conclusion: Our results indicated that previous surgery affected intravascular dissemination and increased the risk of vascular injection. Cohesional area caused by previous surgery complicated the injection. Additionally, fluoroscopy count and operation time were also affected by previous surgery.Yayın Percutaneous radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: Experience in 106 patients(EGE UNIV, 2018) Suslu, Husnu; Suslu, Hikmet Turan; Ozdogan, Selcuk; Guclu, Bulent; Duzkalir, Ali HalukObjective: The aim of our study is to analyse the results of percutaneous radiofrequency trigeminal rhizotomy for treatment of idiopathic trigeminal neuralgia. Methods: We inspected the results of 106 patients with the diagnoses of idiopathic neuralgia that treated with percutaneous radiofrequency trigeminal rhizotomy retrospectively. The scores of visual analog scale(VAS) were noted preoperative and postoperative periods at 1st, 3rd, 6th and 12th months and were used for statistical analysis. Results: Mean age of 106 patients was 67.31 +/- 8.85 years. Duration of symptoms was 19.1 +/- 13.1 months. Duration of symptoms did not change significantly according to gender (p=0.755), or site of trigeminal pain (p=0.158). There was not any statistical significance between gender, effected branch of trigemial nerve and side of the pain. Preoperative mean VAS score was 9.6 +/- 0.75. Postoperative mean VAS score values were 3.25 +/- 2.44 at first month, 3.23 +/- 2.43 at third months, 3.12 +/- 2.78 at sixth months and 2.59 +/- 3.18 at postoperative twelfth months. We found statistically significant difference between preoperative and postoperative 1st, 3rd, 6th and 12th months VAS scores (p<0.001). Conclusion: Percutaneous radiofrequency trigeminal rhizotomy is the minimally invasive treatment modality with lower complication rates and it has a high rate of efficacy when compared with invasive methods. It is most cost-effective procedure to choose if the pain recurs.Yayın Ultrasound guided erector spinae plane block relieves lower cervical and interscapular myofascial pain, a new indication(ELSEVIER SCIENCE INC, 2019) Tulgar, Serkan; Thomas, David Terence; Suslu, Husnu…
