Background: Screw loosening, which is a major problem in dynamic systems, can be easily overcome with 2-stage surgery. In this article, the clinical and radiological results of patients undergoing dynamic stabilization with a Dynesys device in 2 stages are discussed.Methods: A total of 10 male and 13 female adult patients were included in this single-center retrospective study conducted between 2018 and 2021. The mean age of the patients was 65.6 years. All of the patients had pain complaints that affected their daily lives. Bone density T scores were determined with the dual-energy x-ray absorptiometry method before patients were admitted for surgery. In the first surgery, Dynesys system pedicle screws were inserted. After 6 months of osteointegration, Dynesys system spacers and elastic bandages were placed. Preoperative, early postoperative, and late postoperative visual analog pain scale (VAS) scores and Oswestry Disability Index (ODI) scores were determined and statistically compared.Results: Patients were followed for an average of 30 months. Complications and recurrence were not observed. Neurological deficits were not observed after patients recovered from anesthesia. Significant improvement was observed in the ODI and VAS parameters in the preoperative (ODI: 66.2%, VAS: 7.8), early postoperative (ODI: 20.3%, VAS: 2.4), and late postoperative (ODI: 6.8% and VAS: 1.1) periods. Symptomatic improvement was seen in all patients. No screw breakage or loosening was detected by radiological evaluation in any of the patients during the 2-year follow-up period.Conclusions: In our experience, the insufficiency of the proximal and distal end screws is eliminated when 2 stages of dynamic system stabilizations are completed after osteointegration of the screws.

Background: Most people face low back pain problems at least once in their lifetimes. With the advancing technology, people have been consulting the internet regarding their diagnoses more and more over the last 20 years. This study aims to evaluate the accuracy and reliability of YouTube videos on low back pain. Methods: The keyword “Low Back Pain” was used in our search on YouTube. The first 50 videos to come up in the search results were evaluated using JAMA, DISCERN, and GQS scoring systems. The individual correlation of each video and the correlation between the aforementioned scoring systems were statistically analyzed. Results: The average length of the 50 videos that were analyzed is 7,57 minutes (0,34 – 48,23 minutes), and the average daily view count of the videos is 331,14. Generally, video quality was found to be “poor”. On average, JAMA score was 1,64, DISCERN score was 1,63 and GQS score was 1,93. The most common videos found on the subject were those that were done by TV programs. And, videos by health information websites and by Hospitals / Doctors / Educational Institutions were, while still being below the threshold value, found to give higher quality information on the subject than the videos by other sources. Conclusion: Videos on YouTube regarding low back pain are of low quality, and most are created by unreliable sources. Therefore, such YouTube videos should not be recommended as patient education tools on low back pain. An important step in disseminating correct medical information to the public would be to have a platform where the accuracy and quality of given medical information are evaluated by medical experts.

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Background and objectiveSpinal infection (SI) is an infectious disease affecting the vertebral column, spinal cord, and adjacent structures. The infection can occur following interventions or spontaneously. The aim of this study was to highlight the importance of employing a methodological approach for the accurate and rapid diagnosis of SI and to share information on the most effective treatment method, which involves using a diagnostictreatment algorithm that can help with SI management. MethodologyThis study included 50 patients diagnosed with SI between 2016 and 2020. The treatment follow-up period was limited to six months, and the study was conducted as a retrospective cohort analysis. The sample consisted of 22 female patients and 28 male patients, and the mean age of the patients was 50.2 years. All patients received diagnosis and treatment according to the algorithm described in this article. ResultsIn the study group, 60% of patients had an infection in the lumbar spine, 4% in the thoracal spine, 12% in the cervical spine, and 8% in the sacral spine. Previously operated patients were diagnosed on the 30.16th day on average. A total of 19 patients (38%) had no history of undergoing surgery. Radiologically, the most common finding was spondylodiscitis/discitis (32%). Osteomyelitis was detected in one (2%) patient. Methicillin-sensitive Staphylococcus aureus (MSSA) was the most commonly isolated organism in culture results and was detected in 13 patients (26%). The culture results of 12 patients (24%) were negative. The number of patients with active SI who were unstable and stabilized at the time of diagnosis was 11 (22%), and stabilization materials were removed in two patients (4%). In the 6th month of control, the patients did not have any complaints, signs of an infection, or unstable vertebral column. ConclusionsWe conclude that the combined algorithm we recommend for the diagnosis and treatment of patients with SI can prevent negative deviation and is an effective treatment for this condition.