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Is your child glued to their cell phone? Does he or she constantly check online and social media frequently? Looking for viral cat and bunny videos? Then your child may be at risk for mental health. According to a study conducted at Korea University, we should be seriously worried about our children. According to research, 82% of Americans have a smart phone, 92% use a smart phone while shopping, 78% while eating something at home, and even while crossing the street with 44%. According to another study, 73% of young people use smartphones, and 92% of them say they are online on their phones every day. Researchers state that smartphone addiction has reached dangerous levels, especially in young people with internet and smartphone addiction, causing brain chemical imbalances, thus leading to depression and anxiety in these young people. In the study, compared to the control group, GABA (gamma amino butyric acid) and Glx (glutamate-glutamine), which play an important role in behavior in the brain, were found at higher levels in the anterior cingulate cortex. Although technology has an important role in human life; These studies show that we need to limit our children and keep them under control.

The syrinx is cyst cavitation inside the spinal cord. It can occur in congenital, cancer cases or after spinal traumas. There are 2 types: Communicating syringomyelia: It is the enlargement of the central canal in the spinal cord. It is generally associated with foramen magnum anomalies (Chiari Type 1). Noncommunican syringomyelia: This type is mentioned if the cyst is in the spinal cord and not associated with the central canal or in the subarachnoid distance. The actual syrinx cavity contains CSF. It develops very slowly clinically and takes years to progress. Syringomyelia Symptoms: loss of feeling Pain in the neck and nape area It is a loss of strength in the arms and hands. Diagnosis of Syringomyelia; It is placed with MRI. Syringomyelia Treatment Posterior decompression Shunt application Syringostomy, that is, mouth opening of the cyst. Methods such as aspiration of the cyst are used.

Cephal hematoma is the accumulation of blood under the scalp, that is, under the skin. The majority occur in children. There are two types: Subgalile hematoma: It occurs without trauma to the skull bones or in nondisplaced skull fractures, especially in children younger than 1 year old. It can start with a small bleeding and turn into a large bleeding. It is soft and fluctuant. Subperiosteal hematoma: It often occurs in newborns. It is more limited than a subgaleal hematoma. It is limited to sutures. 80% is absorbed within 2-3 weeks. Treatment In general, it does not require treatment and is absorbed within 2-4 weeks.

Godfrey Hounsfield first planned the first tomography scan in 1968, and in 1971, he installed the first prototype computed tomography scanner for clinical trials at Atkinson Morley Hospital in Wimbledon, England. Computed tomography technology was used for the first time to separate a normal brain tissue from a diseased brain tissue. By 1975, devices capable of taking computerized tomography of the whole body began to be marketed. Rumor has it that Alan Cormack (1924 - 1998) independently began working on a mathematical technique that would allow the captured images to be put together. Cormak and Hounsfield shared the 1979 Nobel Prize in Medicine and Physiology. This device designed by Kormak company has revolutionized the field of radiology. MRI is often confused with tomography, but there is a big difference. While magnetic field is used in MRI devices, radiation is used in tomography devices. The tomography device consists of several parts. It shows similarities with the MR device in terms of appearance and working properties. The device has a panel, table and monitor on which x-rays are projected. During viewing, these parts work synchronously. Computed tomography; It is a radiological imaging method for creating a cross-sectional image of the object examined using X-rays. That is, the part of the X-ray beam that passes the object is detected by the detectors placed in front of the X-ray tube and converted into an image. Tube detectors are facing. The controlled beam coming out of the tube is passed through the patient's body and collected through detectors. However, during this irradiation, unlike the x-ray device, the tube and detector are not fixed. It takes images by constantly rotating around the patient. The most important feature that distinguishes tomography from X-ray is that the attenuation of X-rays passing through a thin section of the body is measured with a detector and an image is created with the help of a computer. It is not the principle of casting a shadow of an area, that is, the area taken, on the film, as in an X-ray, but a clear display of all organs by taking cross-sectional images of the irradiated area. The data collected through the detector are evaluated in the computer environment and images are formed. Today, advanced multi-slice spiral computed tomography is generally used. In this device, spiral tomographs were used before, the tube and detectors are designed to rotate around the patient and the table on which the patient lies is constantly moving at a predetermined speed. Spiral tomography was not sufficient to visualize the heart, which is a moving organ. Later, multi-slice spiral computed tomography was developed. The difference from the old types is that it has detectors that are thinner and in more than one row. Later, the tube movement has been accelerated considerably compared to the old versions. Detectors, which were previously in 4 rows, were made to be 64 or more rows. Thus, the resolution of the images has increased and it has become possible to do with breathing under 20 seconds. It is known that nearly 10 million people have tomography in Turkey every year. Tomography devices are advanced technological tools that help in imaging for the treatment of many diseases. Dr. Tamer Tekin

Sciatica, or sciatic pain, describes pain that starts with low back pain and radiates to the hip and leg. Pain usually occurs as a result of lumbar hernia pressing on the nerve, bone compression or muscle tension. Sciatica - Symptoms of Sciatica It starts with back and hip pain. It usually happens on one leg. Sciatica pain extends from the back of the thigh to the knee and leg, and sometimes to the foot. The pain is felt more intensely in the leg than in the waist. The character of the pain; While it is in the form of burning, stinging, cramping, it can vary from mild to severe. Numbness and tingling may also be felt in the leg and foot. The pain is exacerbated because the load on the spine is too much while sitting. Bending, twisting pain increases and decreases while lying down. Sciatica - Causes of Sciatica Piriformis syndrome: It is a condition that occurs as a result of the contraction and spasm of the piriformis muscle pressing on the sciatic nerve. Trauma Lumbar Hernia (lumbar disc herniation) Narrow Canal (spinal stenosis) osteoarthritis Lumbar Slip (spondylolisthesis) Dr. Tamer Tekin

As a result of the hustle and bustle of daily life, strenuous work hours, high technology use and inactivity, there is an increase in herniated disc cases. However, you can prevent lumbar hernia, which occurs in every age group, with a few simple changes in your life. Memorial Service and Bahçelievler Hospitals Brain, Nerve, Spinal Cord and Spine Surgery Specialist Assoc. Dr. Onur Yaman gave information about the causes and treatment methods of herniated disc. DO NOT LIFT HEAVY LOADS, DO NOT MOVE UNCONTROLLED The disc between the vertebrae has important functions. The disc meets the loads on the waist, keeps the upper part of the body upright, and allows the waist to move in all directions. The inside of the disc is more watery and the outside consists of a harder structure. With the advancement of age, the inner nucleus pulposus loses its water structure and the disc distance height, which should be flexible, decreases. The disc distance cannot carry the loads it is exposed to and it starts to come out with the tear that appears on the outer part of the disc. Lifting heavy loads, an uncontrolled movement, traffic accidents or sudden forces exposed in cases of falling from a height cause disc rupture. STAY AWAY FROM OVER WEIGHT AND CIGARETTES TO AVOID A HERNIA Although lumbar hernia is generally a disease of middle-aged people, it can occur in any age group. We can list the risk factors of the disease, which has a higher risk of being seen in those with a family history of herniated disc as follows; • Obesity: Discs that provide spine flexibility are deformed due to the pressure of excess weight and cause herniated disc. You can minimize the risk of herniated disc by losing your excess weight. • Immobility: The neck, back, waist and abdominal muscles are the most important helpers of the spine, which carries the weight of the body. A sedentary life away from exercise weakens the auxiliary muscles, causing the entire load to remain on the spine. The overload placed on the spine causes herniation in the discs. • Lifting heavy loads: People who work in jobs that require heavy physical activity and have to lift heavy loads cause herniation. For this reason, the person should do the work that requires heavy physical activity by protecting his back. • Smoking: Smoking should be avoided so that it does not increase disc degeneration. MAY CAUSE LOSS OF STRENGTH IN YOUR LEG The ruptured disc compresses the nerve root and causes back and leg pain. Lower back pain, which increases when moving and sitting, usually decreases when resting. Leg pains, which are described as sharp and electric shock by the patients, can be seen at different levels of the leg depending on the affected nerve root. With the progression of the disease, numbness and tingling in the legs of the patients, weakness or loss of function in the legs occur. In addition, the compression of the last part of the spinal cord causes the patient's urinary incontinence problem. IF REST DOESN'T GIVE YOU WAIST LEG PAIN... Physical therapy is applied to patients diagnosed with lumbar hernia, if their complaints do not go away despite the use of rest and pain medication. If the patient's pain continues despite the treatments, the patient should be examined with advanced imaging method. If the patient's complaints, examination and imaging methods overlap, surgery is recommended to the patient. By removing the mechanical pressure on the nerves coming out of the spinal cord, the patient is provided to continue his life in a healthy way.

When numbness and pain starts, it requires a very comprehensive treatment process such as the use of painkillers, the use of muscle relaxants, the application of various physical therapy exercises, and the change of diet and lifestyle. In this context, hernia pain can sometimes lead to depression due to severe pain experienced. Medicana International Istanbul Hospital Mental Health and Diseases Specialist (Psychiatrist) Dr. Emel Kurt gave important information about the mental problems due to herniated disc. Treatment of lumbar hernia-related complaints requires long-term follow-up in patients. The most prominent complaint of the patients is related to pain due to herniated disc. Physiologically, we can describe pain formation as the neurons responsible for transmitting the pain sensation, which is common in the body, to the brain, passing through the medulla spinalis (spinal cord), firstly to the brain stem and thalamus, and then to the cortex of the brain (the outer layer of the brain), as a result of which the person receives the pain sensation. Pain is a subjective sensation, it cannot be measured, but the severity of pain can be graded according to one's own experience. Any kind of pain disrupts the biopsychosocial balance of the person. The estimated annual incidence of low back pain is reported to be 5-20% in the USA and 25-45% in Europe. Pain can affect the physical and psychological state of the person, leading to limitation of daily functions. Pain that lasts longer than 3 months is defined as chronic low back pain. Psychiatric disorders or complaints accompany most of those with chronic pain. It is possible to explain this association from both aspects: various psychological factors can cause pain, as well as pain itself can cause psychological problems. chronic pain; It causes symptoms such as irritability-tension, sleep disorders, feelings of burnout, turning one's attention to one's body, sexual reluctance, slowing down in movements, and social withdrawal. These individuals may feel insecure and exhibit chronic pain behavior. They can express pain physically with gestures, facial expressions and groans, they may have difficulty in fulfilling their responsibilities, and they may visit a doctor frequently. Pain can almost become a part of their lives. Chronic Pain Leads to Depression Stating that there is a strong relationship between pain and depression, Psychiatrist Dr. Emel Kurt stated that as chronic pain has a risk of causing depression, depression also has an effect on revealing or increasing the sensation of pain. Chronic pain reduces a person's quality of life. An individual who constantly feels pain may have difficulty in carrying out his responsibilities, may experience reluctance to engage in pleasurable activities, may become intolerant, and interpersonal relationships may deteriorate as a result. All these losses can cause the person to become more and more hopeless about the vicious circle he is in, not being able to fix the broken interpersonal relations with his thoughts that he is not understood by his environment, and ultimately depression. Corticotropin-Releasing Hormone and Arginine-Vasopressin secreted from the brain region called Hypothalamus in acute stress-related situations cause the release of cortisol (glucocorticoid) from the adrenal glands with a series of reactions. This circuit is called the Hypothalamo Ptiter Axis (HPA). Cortisol enables the person to exhibit various physiological and behavioral reactions to stress in the acute period. In the case of chronic stress (for example, chronic pain), the HPA system is disrupted and some hormones such as cortisol rise in the blood. The deterioration in HPA is thought to be related to the depression that occurs in chronic pain states. Considering that patients with depression perceive the pain as more severe, it is predicted that the pain complaints related to the primary disease will decrease with the treatment of depression. When all these are evaluated, it is recommended that patients with lumbar hernia problem causing chronic pain should also be evaluated psychiatrically.

The main exacerbation of the pain in migraine is the enlargement of the head and brain vessels with the effect of the trigeminovascular system on the vessels. Migraine headaches can be seen in childhood or even infancy. However, after the effects of hormones in adolescence and stress factors come into play, the frequency and severity of pain between the ages of 35-45 affect daily life. Patients are born predisposed to hypersensitivity of the nerve. Until 10 years ago, migraine treatment consisted of only pain relievers and drugs used in different diseases. Botulinum toxin is a drug that has found its place as the gold standard treatment in many different fields since 1989, and was approved by the FDA in 2009, specifically for the mechanism of formation of chronic migraine. The effectiveness and safety of the drug has been documented by thousands of studies and patients. There is very clear scientific evidence for its use in migraine. Botulinum toxin significantly increases the number of pain-free days in chronic migraine patients and enables patients to return to daily life with an increase in their quality of life. VACCINE METHOD IN MIGRAINE TREATMENT Drugs used during attacks, ie migraine attacks, are not suitable for long-term use. The first of these is the triptan group drugs that we know to be effective. Botulinum toxin is the only approved treatment option for chronic migraine as an effective and safe treatment in patients with frequent attacks of 15 days or more, since these drugs cannot be used more than 6-8 tablets per month. With the advancement of drug technology, the interest in migraine treatment is increasing. We know that many diseases that could not be cured in the past can now be treated with the biological medicine revolution. However, these drugs are prioritized for the use of life-threatening diseases due to research and development processes and production costs. The drug defined as migraine vaccine (erenumab) is in the biological drug group and is basically not a vaccine. There is no such thing as completely treating and ending migraine. Because it is an injectable product, it has taken this name among the people. This drug blocks the receptors on the vessel to which cgrp substance, which is released from the trigeminal nerve endings and causes the vessels to dilate, is attached. HOW IS THE MIGRAINE VACCINE APPLIED? Erenumab is approved by the FDA for migraine preventive (prophylaxis) use. In patients with monthly headache days between 4 and 15, injection once a month reduced the number of migraine headache days by 50% in approximately 40% of the patients in the 3rd month. It is a treatment option specially developed for migraine in cases such as lifestyle change and insufficiency of acute treatments. However, the balance between monthly treatment costs and the effectiveness of patients on the number of days with headache in real life should be evaluated by a specialist neurologist. This treatment is not yet available in our country and it will take some time before it is approved by the Ministry of Health. Nerve blockades are also among the economical options for patients who cannot benefit enough from conventional drugs in migraine treatment. Botulinum toxin is the most effective and safe drug today for patients with more than 3 migraine attacks per month, 8 days of migraine pain and 15 or more days with headache.

Not all types of brain tumors are cancer. Brain tumors are in two groups as benign (benign) or malignant (malignant): 1. Benign brain tumors do not contain cancerous cells: They are usually surgically removed and very rarely recur. The borders and edges of benign brain tumors are clearly visible. They do not spread to surrounding healthy tissues and do not spread to other parts of the body. However, this does not mean that benign tumors are completely harmless. Benign tumors can sometimes cause serious health problems by pressing on sensitive areas of the brain. Unlike benign tumors in other parts of the body, benign tumors in the brain can be life-threatening from time to time. Very rarely, benign brain tumors can turn into malignant tumors over time. 2. Malignant (malignant) brain tumors contain cancerous cells: Malignant brain tumors are usually more dangerous and are life-threatening. Malignant tumors tend to grow rapidly and spread to surrounding healthy tissues. Rarely, cancer cells may separate from a malignant brain tumor and spread (metastasize) to other parts of the brain, spinal cord, or even to other parts of the body. In some cases, malignant tumors do not spread or spread to healthy tissues. The tumor may become entrapped within a layer of tissue, skull bone, or other structure in the head; These types of tumors are called “encapsulated tumors”. What you need to know about brain tumor What is a brain tumor? What are the symptoms of brain cancer? How are brain tumors classified? What are the diagnostic methods in brain tumors? What are the treatment options for brain tumors? How are radiotherapy and radiosurgery applied in brain tumors? What is a brain tumor? Not all types of brain tumors are cancer. Brain tumors are in two groups as benign (benign) or malignant (malignant): 1. Benign brain tumors do not contain cancerous cells: They are usually surgically removed and very rarely recur. The borders and edges of benign brain tumors are clearly visible. They do not spread to surrounding healthy tissues and do not spread to other parts of the body. However, this does not mean that benign tumors are completely harmless. Benign tumors can sometimes cause serious health problems by pressing on sensitive areas of the brain. Unlike benign tumors in other parts of the body, benign tumors in the brain can be life-threatening from time to time. Very rarely, benign brain tumors can turn into malignant tumors over time. 2. Malignant (malignant) brain tumors contain cancerous cells: Malignant brain tumors are usually more dangerous and are life-threatening. Malignant tumors tend to grow rapidly and spread to surrounding healthy tissues. Rarely, cancer cells may separate from a malignant brain tumor and spread (metastasize) to other parts of the brain, spinal cord, or even to other parts of the body. In some cases, malignant tumors do not spread or spread to healthy tissues. The tumor may become entrapped within a layer of tissue, skull bone, or other structure in the head; These types of tumors are called “encapsulated tumors”. What are the symptoms of brain cancer? Brain tumor symptoms depend on the size, type, and location of the tumor. Symptoms occur when the tumor presses on nerve endings, damages the brain, or the tumor grows and causes fluid to accumulate in the skull. Among the most common symptoms of a brain tumor are: Headache that worsens in the morning Nausea and/or vomiting Changes in speech, vision, or hearing Problems with balance while standing or walking Extreme changes in personality, mood, or ability to concentrate problems with memory, Muscle twitches, contractions, spasms, or seizures There is numbness or tingling sensation in the arms and legs. However, these symptoms are not mostly due to a brain tumor, but can also occur due to another health problem. It is of great importance for people with these symptoms to see a doctor without delay in terms of early diagnosis and treatment. How are brain tumors classified? Brain tumors are classified from low to high according to their grade (first-degree to fourth-degree). The grade of a tumor refers to how the cancerous cells look under the microscope. The cells of high-grade tumors look more abnormal and usually grow faster than low-grade tumors. Primary Brain Tumors Tumors that begin to form in the brain tissue are called primary brain tumors. Primary brain tumors are classified according to the cells they originate from or the brain region. Secondary Brain Tumors Malignant tumor cells in any tissue or organ of the body can reach the brain via blood and cause the formation of a new tumor there. Such tumors may be secondary brain tumors or metastatic

While many patients with coronavirus are able to overcome the disease with mild symptoms, some live more severely. Most of these people are men over the age of 50. British Prime Minister Boris Johnson is one of them. Johnson was hospitalized on the 10th day of his illness when his symptoms worsened; He has been in intensive care since Monday. Receiving oxygen but not connected to ventilator. Who suffers from Covid-19 disease more severely? Some people have a much more severe risk of getting the disease. Chief among these are patients over the age of 70, even if they do not have any other disease. Regardless of age, those with a chronic disease such as heart disease are also at risk. There are 1.5 million people in this category in the UK who would need hospital treatment if they contracted the coronavirus. Among them are people who have previously had cancer and have received chemotherapy. These people are advised not to leave their homes, even if they have recovered now. Although they have not yet been definitively identified as a separate risk group, it has been observed that men in their 50s and 60s are also more affected by the virus, even if they do not have a chronic condition. Scientists are not yet sure what causes this. According to UK data, the average age of patients hospitalized in intensive care due to coronavirus is 60. Most are men, and most of them have ailments such as obesity or heart disease. According to the data of the UK's National Bureau of Statistics, as of March 27, 44 of the 647 people who died due to coronavirus, or 7 percent, were between the ages of 45-65. Mortality rates increase with age for both men and women. However, the rate of men who lost their lives is higher than women. Data from China, the origin of the epidemic, also show that men are more at risk than women. But experts say it's not because of the physical differences between the sexes; He says there may be differences in habits such as smoking. Ian Hall, Professor of Molecular Medicine at the University of Nottingham, said: "I am absolutely convinced that differences in behavior may be the reason for the much higher risk in men. However, other as yet undetermined factors may also play a role." said. Men are more likely than women to have a heart attack, develop diabetes, and have chronic lung diseases. Some experts think that genetics and sex hormones may also play a role. Are women more immune? "It's becoming more and more accepted that there are drastic differences between the immune system of women and men, which has implications for the outcome of many epidemics," says Professor Philip Goulder, who studies the immune system at Oxford University. "Women's immune system's response to vaccines and infectious diseases is much tougher and more effective than that of men." This may be because women carry twice as many X chromosomes as men. Men have the same number of X and Y chromosomes, while women have an X chromosome instead of a Y chromosome. Some critical immune genes are located on the X chromosome. Does the coronavirus cause deaths? Around 600,000 people die each year across the UK. Most of them are those with serious health problems and the elderly. Just like those who lost their lives after the coronavirus was detected... Professor Sir David Spiegelhalter at Cambridge University says that 10 percent of those over 80 will die next year. In the event that they contract the coronavirus, this rate will again be 10 percent. How can you protect yourself? During these times you stay at home, try to protect your health by doing sports at home and eating a balanced diet. If you smoke, now is the perfect time to quit. Here are the things men do more than women throughout their lives: The coronavirus is spread when an infected person coughs and sneezes. When you breathe this air or touch the places where these particles fall, you can also get the virus when you touch your eyes, nose or mouth. For this reason, sneezing or coughing on a tissue, touching your face without washing your hands, and not approaching infected people are also some of the precautions you can take to protect your health.

Narrow and Nerve Surgery Op. Dr. Ozan Ganiüsmen stated that narrow channel disease should not be taken lightly. A PHYSICIAN SHOULD BE CONSIDERED Caused by narrow channel disease Op. Stating that the disease is seen more intensely in middle and upper age groups and people with careless behaviors, Op. Dr. Ganiüsmen said, "In cases such as low back, neck, back pain, spreading of pain in the hips, legs and arms, numbness in the arms and legs, incontinence of urine or stool, cerebrospinal nerve surgery should be applied. Physical therapy, orthopedics and neurology branches are also relevant. Drug use, resting. "And appropriate exercise is usually sufficient. If the symptoms last for a long time, facet blockade can be done with the radio frequency method," he said. On the other hand, stating that surgical decision can be made for some patients, Ganiüsmen said, "Success and patient satisfaction rate in surgical interventions is over 90 percent."

There are two types of stenosis disease, either congenital or acquired. The most common type; It happens due to degenerative arthritis of the spinal joint. In this joint arthritis, the cartilage tissue thins and the joint capsule loosens. Mobility increases and osteophytes appear. Although osteophytes restrict the movement of the mobile segment, the facet joint narrows the spinal canal. It is most commonly seen at L4-5 level. The aging process with secondary changes is one of the most common causes of narrow canal. Two forms of arthritis affect the spine. These are osteoarthritis and rheumatoid arthritis. Osteoarthritis: It is the most common type of arthritis. It occurs in middle age and above. It is chronic. It affects many joints. It occurs in the cartilage tissue layer in the joints. It is accompanied by bone spur and excessive bone development. And it impairs cartilage function. The degenerative process also affects the facet joints and disc. In disc degeneration, it causes enlargement of the facet joints and narrowing of the spinal canal. Rheumatoid Arthritis: It usually affects people from a young age. Although it is not directly related to the narrow canal, it disrupts the synovial membrane in the joint and affects joint function. In patients with rheumatoid arthritis, the most mobile parts of the spinal joints are the most frequently affected. Spinal tumors exert their effects on the spinal canal with inflammation and tissue growth. The occurrence of trauma, spinal fractures, or lumbar dislocation can narrow the canal. Paget's disease is a chronic disease that causes bone growth. The canal may narrow as a result of excessive bone growth and deterioration in bone tissue. The appearance of calcifications in the posterior longitudinal ligament can lead to widening of the ligament and consequent narrowing of the canal. Narrow canal can be divided into two forms as central stenosis and lateral stenosis according to its axial views. In the central stenosis, while the dura and its inner neural elements are compressed; In the lateral forms, the nerve roots are especially compressed in the nerve exit holes, which we call the foramen. Foraminal height normally ranges from 20-23 mm. In the narrow channel, it goes below 15 mm. Compression, venous congestion and neuronal arterial ischemia in these neural vessels and nerves lead to neurogenic claudication in the patient. It appears more often in women than in men. most frequently; It occurs in men and women over the age of 50. However, it can also be seen in younger people at birth or after trauma. The spinal canal can narrow without any symptoms. However, if the spinal cord, nerve roots or cauda equina are compressed as a result of canal stenosis, symptoms of the narrow canal gradually begin to appear. In patients with narrow canal disease in the lumbar spine, narrow canal can also be seen in the neck spine. Physical and clinical findings do not develop suddenly. Low back and leg pain (sciatica) is observed in 95% of patients, and neurogenic claudication is observed in 91%. Neurogenic claudication usually affects both legs. The extent of pain depends on the area of ​​the affected nerve. Patients feel pain and numbness mostly in the hip region or proximal thigh. While bending forward, sitting, lying down reduces the pain; Complaints increase with standing for a long time and bending the waist backwards (bending forward causes enlargement of the spinal canal and pain decreases). Numbness, cramps, weakness (paralysis) may be observed in the legs. Pain does not go away with rest, urinary incontinence may occur. When the patient is asked to walk, the pain starts to intensify after a while and the patient prefers to walk in a forward-leaning posture. When asked to sit, pain complaints begin to decrease. It is very typical for patients with stenosis disease. Rarely, in the advanced stages of the disease, cauda equina syndrome may occur. In the patient, urinary and stool incontinence, deterioration in sexual functions (impotence), weakness in both legs (paralysis), intense numbness and numbness occur. In this case, the patient should be operated on urgently. Dr. Tamer Tekin