Ahmet Yilmaz Sarlak

Kocaeli University, Cocaeli, Kocaeli, Turkey

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Publications (15)25.64 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to examine the health status of early adolescent patients with idiopathic scoliosis using depression-anxiety scales, a generic Quality-of-Life Inventory as well as the Scoliosis Research Society-22 (SRS-22) questionnaire to search for the most comprehensive approach for the measurement of outcomes. Thirty-seven early adolescent patients with idiopathic scoliosis were analyzed within 6-12 months of the postoperative time period. There was no statistically significant correlation between the total score of SRS-22 and the total scores of the pediatric quality-of-life inventory. However, the total scores of SRS-22 were positively correlated with the self-esteem level and negatively correlated with the depression level and State-Trait Anxiety Inventory for Children scores. In early adolescents with idiopathic scoliosis deformity correction, SRS-22 may be inadequate in terms of mental health and physical activity parameters to evaluate overall quality of life.
    Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America 04/2012; 21(4):317-21. · 0.66 Impact Factor
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    ABSTRACT: Retrospective study. To evaluate the radiologic results of fusion with segmental pedicle screw fixation in neglected thoracic congenital curves with a mean follow-up of 51.3 months (range: 24 to 108 mo). Segmental pedicle screw fixation has been shown to be effective both in correcting and controlling the idiopathic spinal deformities. However, the choice of treatment modality is more controversial in neglected thoracic congenital curves of the aged. Fourteen patients with thoracic congenital curves treated by segmental pedicle screw fixation and fusion were analyzed. The average age of the patients was 14.9 years (range: 10 to 25 y) at surgery. Deformity correction was achieved by compression of the convex deformity side with resection of apical 3 ribs. Radiologic analyses of coronal and sagittal plane included Cobb angles of the major compensatory curves, apical vertebrae translation, and sagittal Cobb angles, respectively. In the coronal plane, the preoperative mean major curve Cobb angle of 52.3 degree (range: 32.6 to 66.7 degrees) was corrected to 25.3 degree (range: 7.2 to 44.8 degree) and the mean compensatory curve Cobb angle of 23.6 degree (range: 10.3 to 34.8 degrees) was corrected to 15.9 degree (range: 5.7 to 30.6 degrees). The mean translation of apical vertebrae was 28.8 mm (range: 4.7 to 53.6 mm) before surgery and 15.5 mm (range: 2.4 to 41.3 mm) after surgery. In the sagittal plane, the mean preoperative and postoperative sagittal T5 to T12 angles were 34.8 degree (range: 16.5 to 44.7 degrees) and 27.3 degree (range: 10.4 to 43.5 degrees), respectively. The mean preoperative and postoperative sagittal T12 to S1 angles were 47.2 degree (range: 23.4 to 65.1 degrees) and 41.3 degree (range: 23.8 to 62.7 degrees), respectively. In the neglected thoracic congenital deformities of the aged, with posterior pedicle instrumented fusion, an acceptable correction can be achieved with relatively low morbidity.
    Journal of spinal disorders & techniques 10/2010; 23(8):525-9. · 1.21 Impact Factor
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    ABSTRACT: Pedicle screw fixation is a challenging procedure in thoracic spine, as inadvertently misplaced screws have high risk of complications. The accuracy of pedicle screws is typically defined as the screws axis being fully contained within the cortices of the pedicle. One hundred and eighty-five thoracic pedicle screws in 19 patients that were drawn from a total of 1.797 screws in 148 scoliosis patients being suspicious of medial and lateral malpositioning were investigated, retrospectively. Screw containment and the rate of misplacement were determined by postoperative axial CT sections. Medial screw malposition was measured between medial pedicle wall and medial margin of the pedicle screw. The distance between lateral margin of the pedicle screw and lateral vertebral corpus was measured in lateral malpositions. A screw that violated medially greater than 2 mm, while lateral violation greater than 6 mm was rated as an "unacceptable screw". The malpositions were medial in 20 (10.8%) and lateral in 34 (18.3%) screws. Medially, nine screws were rated as acceptable. Of the 29 acceptable lateral misplacement, 13 showed significant risk; five to aorta, six to pleura, one to azygos vein and one to trachea. The acceptability of medial pedicle breach may change in each level with different canal width and a different amount of cord shift. In lateral acceptable malpositions, the aorta is always at a risk by concave-sided screws. This CT-based study demonstrated that T4-T9 concave segments have a smaller safe zone with respect to both cord-aorta injury in medial and lateral malpositions. In these segments, screws should be accurate and screw malposition is to be unacceptable.
    European Spine Journal 07/2009; 18(12):1892-7. · 2.47 Impact Factor
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    ABSTRACT: Tilt fracture is the most unusual variant of pelvic lateral compression injury. The major problem was reported to be protrusion of the pubic ramus into the perineum by posterior-inferior displacement of the fragment. Tilt fragment with anterior and inferior displacement has not been reported in English speaking literature to our knowledge. Anterior tilt fragment can cause significant morbidity in terms of vascular injury, pelvic stability and acetabular fracture.
    Injury 06/2009; 40(10):1036-9. · 1.93 Impact Factor
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    ABSTRACT: Retrospective study. To evaluate the radiological results of fusion with segmental pedicle screw fixation in juvenile idiopathic scoliosis with a minimum 5-year follow-up. Progression of spinal deformity after posterior instrumentation and fusion in immature patients has been reported by several authors. Segmental pedicle screw fixation has been shown to be effective in controlling both coronal and sagittal plane deformities. However, there is no long term study of fusion with segmental pedicle screw fixation in these group of patients. Seven patients with juvenile idiopathic scoliosis treated by segmental pedicle screw fixation and fusion were analyzed. The average age of the patients was 7.4 years (range 5-9 years) at the time of the operation. All the patients were followed up 5 years or more (range 5-8 years) and were all Risser V at the most recent follow up. Three dimensional reconstruction of the radiographs was obtained and 3DStudio Max software was used for combining, evaluating and modifying the technical data derived from both 2d and 3d scan data. The preoperative thoracic curve of 56 +/- 15 degrees was corrected to 24 +/- 17 degrees (57% correction) at the latest follow-up. The lumbar curve of 43 +/- 14 degrees was corrected to 23 +/- 6 degrees (46% correction) at the latest follow-up. The preoperative thoracic kyphosis of 37 +/- 13 degrees and the lumbar lordosis of 33 +/- 13 degrees were changed to 27 +/- 13 degrees and 42 +/- 21 degrees , respectively at the latest follow-up. None of the patients showed coronal decompensation at the latest follow-up. Four patients had no evidence of crankshaft phenomenon. In two patients slight increase in Cobb angle at the instrumented segments with a significant increase in AVR suggesting crankshaft phenomenon was seen. One patient had a curve increase in both instrumented and non instrumented segments due to incorrect strategy. In juvenile idiopathic curves of Risser 0 patients with open triradiate cartilages, routine combined anterior fusion to prevent crankshaft may not be warranted by posterior segmental pedicle screw instrumentation.
    Scoliosis 02/2009; 4:1. · 1.31 Impact Factor
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    ABSTRACT: The axial pullout strength of pedicle screws that were at different temperatures when inserted was compared in calf vertebrae. To determine if insertional temperature of the screw itself affects pullout strength. Fixation stability of pedicle screws depend on several factors. The development of alternate insertion techniques and screw designs were used to improve the stability. Polymethylmethacrylate and calcium sulfate augmentation have been shown to be viable options for improving fixation; but have the potential disadvantages. Three cadaveric thoracic calf spines were instrumented between T1-T10 bilaterally with one type of pedicle screws stored at different insertional temperatures. The axial pullout tests were performed at cross head speed of 5 mm/min. Pullout loads and displacement were recorded at 1/20 seconds intervals until failure occurred. The highest pullout force was obtained with the screws inserted at 4 degrees C. These screws had a 19% increase in pullout strength compared with the screws inserted at 24 degrees C. The highest force/torque proportion was gained in the same group as 0.30 kn/Nm. The technique showed increased pullout force with the screws inserted at 4 degrees C. Using pedicle screws stored at 4 degrees C before instrumentation, seems reasonable in an attempt to obtain a better bone-screw interface.
    Spine 10/2008; 33(19):E667-72. · 2.16 Impact Factor
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    ABSTRACT: In posterior pedicle screw instrumentation of thoracic idiopathic scoliosis, screw malposition might cause significant morbidity in terms of possible pleural, spinal cord, and aorta injury. Preoperative axial magnetic resonance images (MRI) in 12 consecutive patients with right thoracic adolescent scoliosis, all with King type 3 curves, were analyzed in order to evaluate the relationship between the inserted pedicle screw position to pleura, spinal cord, aorta. Axial vertebral images for each thoracic level were scanned and the simulation of pedicle screw insertion was performed using a digital measurement programme. The angular contact value for each parameter regarding the pleura and spinal cord was measured on both sides of the curve. The aorta-vertebral distance was also measured. Aorta-vertebral distance was found to be decreasing gradually from the cephalad to the caudad with the shortest distance being measured at T12 with a mean of 1.2 mm. Concave-sided screws on T5-T9 and convex-sided screws on T2-T3 had the greatest risk to spinal cord injury. Pleural injury is most likely on T4-T9 segments by the convex side screws. T4-T8 screws on the concave side and T11-T12 screws on the convex side may pose risk to the aorta. This MRI-based study demonstrated that in pedicle instrumentation of thoracic levels, every segment deserves special consideration, where computer scanning might be mandatory in immature spine and in patients with severe deformity.
    European Spine Journal 06/2008; 17(5):657-62. · 2.47 Impact Factor
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    ABSTRACT: Primary muscular Echinococcus infection is very rare without involvement of thoracic and abdominal organs. In this case a 31-year-old man who had a growing mass in the postero-medial part of his right thigh was examined. The mass was diagnosed as hydatid cyst using ultrasound, magnetic resonance imaging (MRI) and serological tests. It was removed surgically and there has been no recurrence one year after the surgery. The MRI imaging characteristics may differ depending on the life cycle stage of the parasite. In this case report, we discuss the imaging characteristics of the muscular hydatid cyst with special emphasis on the MRI findings. In regions where hydatidosis is endemic, a mass found in body muscles should be considered as a muscular hydatid cyst.
    Clinical and investigative medicine. Medecine clinique et experimentale 02/2008; 31(5):E296-9. · 1.15 Impact Factor
  • Orthopedics 02/2008; 31(1):95. · 1.05 Impact Factor
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    ABSTRACT: Although several studies have been reported on the adult vertebral pedicle morphology, little is known about immature thoracic pedicles in patients with idiopathic scoliosis. A total of 310 pedicles (155 vertebrae) from T1 to T12 in 10-14 years age group were analyzed with the use of magnetic resonance imaging and digital measurement program in 13 patients with right-sided thoracic idiopathic scoliosis. Each pedicle was measured in the axial and sagittal planes including transverse and sagittal pedicle width and angles, chord length, interpedicular distance and epidural space width on convex and concave sides of the curve. The smallest transverse pedicle widths were in the periapical region and the largest were in the caudal region. No statistically significant difference in transverse pedicle widths was detected between the convex and concave sides. The transverse pedicle angle measured 15.56 degrees at T1 and decreased to 6.32 degrees at T12. Chord length increased gradually from the cephalad part of the thoracic spine to the caudad part as the shortest length was seen at T1 convex level with a mean of 30.45 mm and the largest length was seen at T12 concave level with a mean of 41.73 mm. The width of epidural space on the concave side was significantly smaller than that on the convex side in most levels of the curve. Based on the anatomic measurements, it may be reasonable to consider thoracic pedicle screws in preadolescent idiopathic scoliosis.
    European Spine Journal 09/2007; 16(8):1203-8. · 2.47 Impact Factor
  • Tuğrul Alici, Levent Buluç, Bilgehan Tosun, Ahmet Yilmaz Sarlak
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    ABSTRACT: We reviewed the results of a modified Judet's quadricepsplasty in eleven patients with inability to fully flex the knee. The patients were examined at an average follow-up of 49 months (4 to 108 months). Their mean pre-operative knee flexion was 30 degrees (range 10 degrees -50 degrees ). At the final follow-up the mean active flexion was improved to 100 degrees (range 70 degrees -130 degrees ) with an average flexion gain of 70 degrees (range 45 degrees -100 degrees ). None of the patients developed an extension lag. According to Judet's criteria, the results were three excellent, seven good and one fair. Staged quadricepsplasty is a useful procedure to correct the disabling flexion loss in the knee.
    The Knee 09/2006; 13(4):280-3. · 2.01 Impact Factor
  • Hakan Gündeş, Levent Buluç, Yavuz Cirpici, Ahmet Yilmaz Sarlak
    Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 01/2006; 15(5):e13-5. · 1.93 Impact Factor
  • Foot & Ankle International 05/2005; 26(4):332-5. · 1.47 Impact Factor
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    ABSTRACT: We present histopathologic and imaging features, treatment alternatives, and follow-up of a patient with a secondary chondrosarcoma of talus. A 27-year-old man with a chondrosarcoma arising from a preexisting benign tumor was treated by talectomy. At 3 years' follow-up, there is no evidence of recurrence or metastasis. The patient can walk with slight limp without the aid of external support.
    The Journal of Foot and Ankle Surgery 01/2005; 44(4):292-6. · 0.86 Impact Factor
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    ABSTRACT: A 13-year-old male achondroplastic dwarf with fixed thoracolumbar kyphosis was treated by segmental pedicle screw fixation, posterolateral fusion combined with one stage two level posterior column resection. Preoperative and postoperative kyphosis angles were 97 and 32 degrees, respectively. Combination of segmental pedicle instrumentation with posterior column resection is a treatment option even in immature achondroplastic patients.
    European Spine Journal 09/2004; 13(5):458-61. · 2.47 Impact Factor

Publication Stats

80 Citations
25.64 Total Impact Points

Institutions

  • 2005–2012
    • Kocaeli University
      • Department of Orthopedics and Traumatology
      Cocaeli, Kocaeli, Turkey
  • 2007
    • State Hospital of Ercis, Turkey
      Arcis, Van, Turkey