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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.

IntroductionSurgical clipping of superior hypophyseal artery (SHA) aneurysms is a challenging task for neurosurgeons due to their close anatomical relationships. The development of endovascular techniques and the difficulty in surgery have led to a decrease in the number of surgical procedures and thus the experience of neurosurgeons in this region. In this study, we aimed to reveal the microsurgical anatomy of the ipsilateral and contralateral approaches to SHA aneurysms and define their limitations via morphometric analyses of radiological anatomy, three-dimensional (3D) modeling, and surgical illustrations.MethodFive fixed and injected cadaver heads underwent dissections. In order to make morphometric measurements, 75 cranial MRI scans were reviewed. Cranial scans were rendered with a module and used to produce 3D models of different anatomical structures. In addition, a medical illustration was drawn that shows different sizes of aneurysms and surgical clipping approaches.ResultsFor the contralateral approach, pterional craniotomy and sylvian dissection were performed. The contralateral SHA was reached from the prechiasmatic area. The dissected SHA was approached with an aneurysm clip, and maneuverability was evaluated. For the ipsilateral approach, pterional craniotomy and sylvian dissection were performed. The ipsilateral SHA was reached by mobilizing the left optic nerve with left optic nerve unroofing and left anterior clinoidectomy. MRI measurements showed that the area of the prechiasm was 90.4 ± 36.6 mm2 (prefixed: 46.9 ± 10.4 mm2, normofixed: 84.8 ± 15.7 mm2, postfixed: 137.2 ± 19.5 mm2, p < 0.001), the distance between the anterior aspect of the optic chiasm and the limbus sphenoidale was 10.0 ± 3.5 mm (prefixed: 5.7 ± 0.8 mm, normofixed: 9.6 ± 1.6 mm, postfixed:14.4 ± 1.6 mm, p < 0.001), and optic nerves’ interneural angle was 65.2° ± 10.0° (prefixed: 77.1° ± 7.3, normofixed: 63.6° ± 7.7°, postfixed: 57.7° ± 5.7°, p: 0.010).ConclusionAnatomic dissections along with 3D virtual model simulations and illustrations demonstrated that the contralateral approach would potentially allow for proximal control and neck control/clipping in smaller SHA aneurysm with relatively minimal retraction of the contralateral optic nerve in the setting of pre- or normofixed chiasm, and ipsilateral approach requires anterior clinodectomy and optic unroofing with considerable optic nerve mobilization to control proximal ICA and clip the aneurysm neck effectively.

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