Prof. Mehmet ZileliTurkey
Sanko University Neurosurgery Department
| 2023 to present | Faculty member Sanko University |
| 1986 - 2023 | Faculty member, Ege University, Izmir, Turkey |
| 2024 - | Chair, WFNS Education & Training Committee |
| 2017 - 2021 | Chair, WFNS Spine Committee |
| 2010 - 2014 | President, World Spinal Column Society |
| 2006 - 2008 | President, Turkish Neurosurgical Society |
Professor Mehmet Zileli is the Chairperson of the WFNS Education & Training Committee and the Honorary President of the Middle East Spine Society.
He was the first and founding President of the Spine Section of the Turkish Neurosurgical Society (1995-1999), President of the Turkish Neurosurgical Society (2006-2008), President of the Turkish Neurosurgery Board (2010-2012), President of the World Spinal Column Society (2010-2014), President of the Middle East Spine Society (2011-2015), President of the Asia Pacific Cervical Spine Society (2014-2015), and Chairman of the WFNS Spine Committee (2017-2021).
He is the author or co-author of 205 scientific articles, editor of 11 books, and author of 25 international and 82 national book chapters. He has presented thousands of papers and lectures at international and national meetings. He is a member of 14 national and 20 international medical societies. He is the editorial board member and/or reviewer of 35 scientific medical journals.
Management of Recurrent Lumbar Disc Herniation
1109 10:35-10:45
Spine/304A
Recurrence of lumbar disc herniation is a common complication of disc surgery, the incidence range between 5-15%. This talk will cover the following titles of lumbar disc herniation recurrence: (1) Definition and incidence of recurrence after lumbar disc surgery; (2) Prediction of recurrence before primary surgery; (3) Prevention of recurrence by surgical measures; (4) Prevention of recurrence by postoperative measures; (5) Treatment options for recurrent disc herniation; (6) The outcomes of recurrent disc herniation surgery.
There are multiple risk factors predicting LDH recurrence, including smoking, younger age, male gender, obesity, diabetes, disc degeneration, and the presence of lumbosacral transitional vertebrae. The level of lumbar discectomy surgery and the amount of disc material removed do not correlate with the recurrence rate. Minimally invasive discectomies may have higher recurrence rates, especially during the surgeon’s learning period. However, the surgeon's experience is not related to recurrence. High-quality studies are needed to determine if activity restriction, weight loss, smoking cessation, and muscle-strengthening exercises after primary surgery can help prevent the recurrence of LDH. The best treatment option for recurrent disc herniation is still being discussed. While complications of minimally invasive techniques may be lower than open discectomy, outcomes are similar. Fusion should only be considered when spinal instability and/or spinal deformity are present. Clinical outcomes and patient satisfaction after recurrent disc herniation surgery are inferior to those after initial discectomy.
We will also summarize the recommendations of the Spine Committee of the World Federation of Neurosurgical Societies (WFNS).
How To Prevent Operating Films, Not the Patient?
1109 08:40-08:50
Spine/304A
Identification of the source of pain in degenerative spinal disorders is not easy. Besides, incidental radiologic pathology and back/ leg pain are common. The matter is not well discussed in the literature, and incidental radiology and surgery in degenerative diseases have not been a research subject.
However, radiologists may report disc herniation in lumbar MR images of 25% of the adult population. In a large series, 40% of individuals under 30 years of age had lumbar intervertebral disc degeneration (LDD). The prevalence of LDD has increased progressively to over 90% by 50 to 55 years of age. Similarly, thoracic disc herniation prevalence rates were reported as 6.5%, and thoracic hypertrophied ligament flavum causing stenosis 19%.
In 2012, the National Physicians Alliance’s project declared guidelines “Promoting Good Stewardship in Clinical Practice.” These guidelines can lead to higher-quality care and better use of finite clinical resources. One of the top five recommendations is “Don’t do imaging for low back pain within the first six weeks unless red flags are present.”
Not imaging patients with acute low back pain will reduce harm and costs without affecting clinical outcomes.
In conclusion, to prevent operating films, not the patient, we recommend not ordering films in unnecessary conditions, more training, and teaching patient evaluation/examination methods more than surgical techniques.