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AIM:To assess the frequency of thoracolumbar junction (TLJ) fractures (T10-L2) in survivors of the 2023 East Turkey earthquake. MATERIAL and METHODS:This single-center retrospective stdy evaluated 10 earthquake survivors, who were trapped under the rubble and rescued alive by rescue teams, and were assessed for spinal trauma after the earthquake in Eastern Turkey on February 6, 2023. All patients underwent full spinal magnetic resonance imaging and computed tomography examinations to determine the level of spinal fracture and decide the treatment methods. RESULTS:All patients had sustained spinal fractures. Eight underwent surgery, while two were managed conservatively. Nine out of ten patients had TLJ fractures. Five patients had L1 fractures, four of them were treated surgically. Three patients had a T12 level fracture, two of whom were treated surgically. One patient with a T7-level fracture was treated surgically. Only one patient had multiple fractures (T12 and L2 levels) and was treated surgically. CONCLUSION:The TLJ was the commonest vertebral fracture level as of the 2023 Turkey earthquake survivors in our study population. In the event of an earthquake, people tend to attain a fetal posture (fix and hyperflex the spine) when taking shelter in a narrow area (triangle of life). This position might place an excessive load on the TLJ, predisposing it to injuries.

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Objective This study aimed to evaluate morphological features of the anterior clinoid process (ACP) and the optic strut (OS) in Chiari malformation Type I (CM-I). Methods The study universe consisted of computed tomography images of 41 CM-I patients and 45 normal subjects. Comparison of the parameters for CM-I and the control group was performed with the Student's t-test. A “p < 0.05” was accepted as the significance level. Results ACP length was smaller in CM-I than the control group (p < 0.001). In contrast to ACP length, ACP angle (p < 0.001), OS length (p = 0.022), and the distance between ACP and OS (p = 0.020) were found greater in CM-I in comparison to the control group (p < 0.05). ACP width (p = 0.233) and OS width (p = 0.376) were similar in both groups. ACP pneumatization in CM-I group was found as 12.20%, whereas in the control group as 8.90%. Two different types about the pneumatization were identified in CM-I group (Type 1: 4.9% and Type 2: 7.3%), whereas three different types in the control group (Type 1: 3.3%, Type 2: 4.4%, and Type 3: 1.1%). Relative to ACP, three different types about OS position were identified in CM-I group (Type C: 31.70%, Type D: 64.60%, and Type E: 3.70%) and the control group (Type C: 7.80%, Type D: 64.40%, and Type E: 27.80%). Conclusions Shorter ACP, wide-angled ACP, longer OS, and more anteriorly located OS were found in CM-I group compared with the normal group. Our findings showed that the pneumatization of ACP was not affected by CM-I.

Abstract Aim of the Study: Clinical consequences of endoscopic endonasal approach (EEA) for Cushing Diseases (CD) were investigated in a single-center series based on definitions and assessments of recurrence and remission. Materials and Methods: 825 patients evaluated, including 64 patients with CD, who underwent EEA at the Ankara University Neurosurgery Department and evaluated retrospectively between the years 2014 and 2021. Postoperative next-morning cortisol and adrenocorticotrophic hormone (ACTH) values were used to assess postoperative endocrinological remission. Results: Twenty-two patients had macroadenoma, and 40 had microadenoma. In 2 patients, no lesions were detected in the sellar region, a diagnosis of magnetic resonance imaging (−) CD was made. Clinical and biochemical follow-ups in Cushing's disease are very important due to risk of recurrence. Regardless of remission, the effect of duration of glucocorticoid use after surgery on recurrence was examined. Glucocorticoid therapy was given in 46 patients (71%) after pituitary surgery. No recurrence was observed in 20 patients whose treatment duration was longer than 1 year. In 12 patients, the glucocorticoid therapy duration was ranged from 6 months to 12 months, and 4 patients showed recurrence. The glucocorticoid therapy duration of >6 months predicted that recurrence would not occur (p 6 months after surgery predicts that recurrence will not occur. Long-term glucocorticoid therapy after surgery suggests surgical success. The mainstay of CD treatment is appropriate postoperative follow-up and administration of the necessary medical and surgical interventions. Keywords: ACTH, Cortisol, Cushing disease, Endonasal endoscopic approach, Recurrence, Remission ÖZET Çalışmanın Amacı: Bu çalışmada, Cushing Hastalığı (CH) için endoskopik endonazal yaklaşımın (EEY) klinik sonuçları, remisyon ve nüks tanımları ve değerlendirmelerine dayalı olarak tek merkezli bir seride araştırıldı. Gereç ve Yöntemler: Ankara Üniversitesi İbni Sina Hastanesi Nöroşirürji Anabilim Dalı'nda 2014-2021 yılları arasında EEY uygulanan 825 hasta arasında CH’ lığı tanısı alan 64 hastanın verileri retrospektif olarak değerlendirildi. Postoperatif ertesi sabah kortizol ve adrenokortikotropik hormon (ACTH) değerleri postoperatif endokrinolojik remisyonu değerlendirmek için kullanıldı. Bulgular: Yirmi iki hastada makroadenom ve 40 hastada mikroadenom saptandı. 2 hastada sellar bölgede lezyon saptanmadı, manyetik rezonans görüntüleme (-) CH tanısı kondu. Kırk hasta kadın, 12 hasta erkekti. CH'de yüksek nüks insidansı nedeniyle, yıllık klinik ve biyokimyasal takipler çok önemlidir. Remisyondan bağımsız olarak ameliyat sonrası glukokortikoid kullanım süresinin nüks üzerine etkisi incelendi. Hipofiz cerrahisi sonrası 46 hastaya (%71) glukokortikoid tedavisi verildi. Tedavi süresi 1 yıldan uzun olan 20 hastada nüks gözlenmedi. 12 hastada glukokortikoid tedavi süresi 6 ay ile 1 yıl arasında değişmekteydi ve 4 hastada nüks görüldü. 6 aydan uzun glukokortikoid tedavi süresinin nüksün olmayacağını saptadığı öngörüldü (p