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Aims: This study aimed to determine whether a systemic inflammatory response occurs in patients with spinal synovial cysts (SSC) and patients with lumbar disc herniation. Methods: Patients who underwent surgery for SSC or lumbar disc herniation between 2016-2022 were included in the study. To compare the results of these patients, patients who applied to the outpatient clinic due to headaches but did not find any abnormal findings in the radiological examinations were also included. Age, gender, duration of stay in the hospital, comorbidity, and histopathological evaluation results were recorded for all patients. The lumbar T2 weighted MR sagittal and axial images obtained on admission to the hospital were examined. The venous blood samples taken from the patients on first admission to the hospital were analyzed biochemically. Results: There was no statistical difference between the three groups regarding age, gender, and blood biochemistry parameters. Furthermore, no statistical difference was found between SSC patients and patients with lumbar disc herniation in age, gender, cyst or herniated disc localization levels, comorbidity, and blood biochemistry analysis results. Correlation analysis for the findings of all patients revealed that no parameters were correlated with the study groups. ROC-Curve test and Logistic Regression tests showed that no parameter could be a predictive marker in differentiating SSC from disc herniation. Conclusion: Study results demonstrated that neither SSC nor disc herniation caused a systemic inflammatory or allergic reaction in the patients. In addition, it was determined that no biochemical parameter could distinguish disc herniation from SSC.

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Introduction: Low back pain accompanied by the lumbosacral transitional vertebra (LSTV) is called the Bertolotti syndrome. This report discussed a case treated with combined corticosteroid and local anesthetic injections based on the literature. Case report: A 35-year-old female patient was admitted to the hospital suffering from low back pain. On neurological exam, her left sacroiliac joint was painful on palpation. Her muscle strength was full, but the left patella reflex was hypoactive. X-ray images revealed “Castellvi Type IIa” LSTV on the left side; therefore, it was considered that the patient might have Bertolotti Syndrome. Because şhedid not accept surgical intervention, “betamethasone dipropionate+betamethasone sodium” and “bupivacaine hydrochloride” were injected into her bilateral sacroiliac joints, bilateral L3-4, and L4-5 facets, and left LSVT joint under fluoroscopy. Her low back pain vanished immediately after the procedure, and she was discharged from the hospital with a full recovery. With an interval of about six months, she was hospitalized 5 more times with complaints of recurrent low back pain, and at each hospitalization, "local anesthetic" (LA) alone or "local anesthetic+corticosteroid" (LA+S) combination was injected into the primary trigger zones. During long-term follow-up, she continued his daily life without any problems. Discussion: This case report showed that sequential LA and LA+S administrations could be curative for patients with Bertolotti syndrome who do not accept surgical treatment, or who cannot undergo surgical intervention. Thus, it was concluded that it would be beneficial to conduct studies with larger samples to obtain more precise information about this method.

In neurosurgical practice, traumatic acute subdural hematoma is frequent cause of mortality and morbidity on traumatic patient. At presence of neurological deficits, immediate surgical intervention must be considered. On the other hand sometimes surgical intervention does not necessary at carefully elected cases which have relatively good neurological condition. As some researches showed it is possible to spontaneous rapid resolution on acute traumatic subdural hematomas under close follow-up. A patient has got trauma on his face in a box match diagnosed as acute traumatic subdural hematoma. The subdural hematoma completely regressed at control cranial tomography imaging after 3 hours of trauma. Various mechanism and predictive symptoms about rapid resolution of acute traumatic subdural hematoma put forwarded in literature but further studies still needed to explain true pathophysiology.