Onder Ofluoglu

Minimally Invasive Management of Spinal Metastases

In most patients who have spinal metastases, treatment is mainly palliative. The conventional surgical methods carry higher risks of complications and postoperative morbidity. Minimally invasive spinal interventions seem to be reasonable alternatives to treat spinal metastatic disease. These procedures can result in less soft tissue trauma, lower blood loss, shorter hospitalization time and are better tolerated by the patients. In this review, the techniques and results of minimally invasive management in spinal metastasis, including percutaneous image-guided interventions (vertebroplasty, kyphoplasty, and radiofrequency ablation) and minimally invasive surgical techniques (endoscopic and minimal access operations), are presented.

Diagnosis and planning in the management of musculoskeletal tumors: surgical perspective.

The evaluation of musculoskeletal tumors requires a close interaction between the orthopedic oncologist, radiologist, and the pathologist. Successful outcome can be achieved in a considerable number of patients by following the appropriate diagnostic strategies and staging studies. The aim of this article is to outline the presentation, imaging, and staging of the primary and metastatic bone and soft tissue tumors. Some of the image-guided interventions for these tumors are also presented.

A case report of osteoblastoma on the distal phalanx of the ring finger successfully treated with curettage and polymethylmethacrylate filling

Highlights • This is the first report of osteoblastoma on the distal phalanx. The finger was monitored closely for two years; sequential films showed a radiopaque interface and no evidence of local recurrence.

Systematic Evaluation of Drug-Loaded Hydrogels for Application in Osteosarcoma Treatment

This is a literature review of studies focusing on the preparation of hydrogels for use as oncological drug delivery systems in the treatment of osteosarcoma (OS). The databases of the US National Library of Medicine National Institutes of Health, Embase, OVID, and Cochrane Library, and the references of retrieved studies, were traced from 1843 to December 21, 2015, without language restrictions. The obtained data were evaluated by complementary statistical methods. Potentially relevant studies were found and included in the analysis. OS-specific chemotherapeutic agents can be successfully embedded within the hydrogels and these drug-loaded hydrogels can be applied locally, rather than systemically, without organ tissue toxicity. Further, OS-specific drug-loaded hydrogels significantly increased tumor inhibition and decreased osteolysis and lung metastases. Drug-loaded hydrogels could be useful in the treatment of OS, although their development remains at the experimental phase. Following evaluation of their application in surgery and the completion of drug release kinetics studies, drug-loaded hydrogels could be tested on living mammals in large samples with the aim of applying these in clinical settings. In the future, development of such drug delivery systems and application of targeted approaches against osteosarcoma and other malignancies may render surgery, radiotherapy and chemotherapy unnecessary.

Spine Oncology: Daedalus, Theseus, and the Minotaur

Over the past three decades, progress has been dramatic in the management of spine tumors. For example, advanced imaging technologies made available at manageable costs have lowered the threshold for scanning. CT, MRI, and PET imaging modalities have greatly enhanced the ability of the surgeon to accurately delineate the extension of the lesion within the bone, the soft tissue, and the spinal canal. Such enhancements have led to great leaps forward in preoperative planning and postoperative evaluation, including improved reconstruction options are resulting in improved outcomes. This article introduces the theme of this volume.

Intra-articular osteoid osteoma in the ischial spine of a 5-year-old child.

Joint Bone Spine - In Press.Proof corrected by the author Available online since mercredi 1 fevrier 2017

Anterior cervical fusion with interbody cage containing beta-tricalcium phosphate: Clinical and radiological results

Aim Beta tricalcium phosphate (beta-TCP) is an osteoconductive, resorbable material. Its clinical effectiveness has been proved in many indications. This study was clinical and radiographic study report obtained in patients undergoing anterior cervical discectomy and fusion ACDF in which PEEK cages were filled beta-TCP in an injectable form. Material and methods Between January 2010 and June 2011, 16 consecutive patients underwent ACDF using PEEK cages with beta-TCP. The cohort compromised 10 men and 6 women with a mean age of 45.2 years. The surgery was performed when the patient had myelopathy or radiculopathy with progressive neurological deficit, or failure of conservative treatment (a minimum of 3 months). The patients were evaluated by Odom criteria preoperatively and postoperative 3rd, 6th, 12th and 24th months. Preop and postop pain was evaluated with visual analogue scala (VAS). Disc height and fusion success rates were evaluated. Results Preoperative average VAS score was 7.9 (7–10) for neck pain and 8 (7–10) for arm pain. At the final follow-up, these scores became 1.5 and 1.4 for neck and arm pain, respectively. The average improvement rate was 81% for neck pain and 82.5% for arm pain. Postop ODOMs criteria main rate was 3.4. Bone fusion was achieved in 14 segments (70%) at 3rd month, 19 segments (95%) at 12th month follow-up assessment. Conclusion Clinical and radiological results revealed that B-TCP is a good alternative synthetic fusion material for cervical interbody fusion. Level of evidence: Level IV, therapeutic study.

Is it Possible to Expedite Studies on the Effects of Pharmacological Agents on Primary Cell Cultures Obtained from High-grade Fibular Osteosarcoma?

Cell culture and primary cell cultures have been widely used in research in many fields of medicine, particularly cancer research. With the help of cell culture studies, the underlying molecular mechanisms and effects of pharmacological agents have been determined to a great extent. The tumor tissue used for osteosarcoma primary cell culture was obtained from resection surgery carried out in cases with proximal fibula fibroblastic osteosarcoma after three multiagent (neoadjuvant) chemotherapy treatments. The present study not only describes how to prepare human primary osteosarcoma (OS) cell cultures but also encourages and guides orthopedic surgeons in how to set up an in vitro experiment for a drug research.

Epithelioid hemangioendothelioma of the craniocervical junction; case report and review

Epithelioid hemangioendotheliomas are uncommon vascular neoplasms and their spinal location is even rarer. We report clinical course of a 31-year-old man with an epithelioid hemangioendothelioma at the cranio-cervical junction. A cervical magnetic resonance imaging revealed tumor that caused posterior cervical cord compression. C1,2,3 total laminectomy and surgical excision of the tumor was performed. Postoperative external beam radiation was performed on the surgical field especially around the right vertebral artery. At 2-year follow-up there was no neurological deficit and no tumor recurrence.