Background and aim: Midline closure defect malformation is a congenital fusional defectof the posterior segments of spinal vertebrae. OHD is associated with high morbidity and mortality.This study investigated total antioxidant and total oxidant status, osteopontin and fetuin-A values inpatients with OHD and found out their distribution in different patient groups. It aims to suggestmeasures in order to reduce OHD malformations in the family and community.Methods: The study was carried out between November 2015 and April 2018 at HarranUniversity Research and Practice Hospital Neurosurgical outpatient clinic and clinic, Neonatal andChild Diseases clinic. The research included patients between 0-5 years old; group 1 with SpinaBifida Occulta (n = 22), group 2 with Spinal Meningocele or Myelomeningocele (n = 26), group 3with Hydrocephalus (n = 31), a total of 80 patients with middle line fold closure defects and 85control group patients between 0-5 age without midline fold closure defects. After the examination,hemogram, blood biochemistry, coagulogram were taken. Serum samples were collected and thenfetuin-A, osteopontin and total antioxidant status (TAS) and total oxidant status (TOS) of thecytokines which affecting OHD were investigated in this serum samples.Results: We did not find any significant differences in TAS value. But we found outsignificant differences in TOS, OSI, fetuin-A, osteopontin values (p <0.05 for all) between patientsand control groupsTOS in the case group was 12.31 ± 3.19. Osteopontin was 4,69 ± 2,90. Fetuin-A was 1.03± 0.48. OsI 1,06 ± 0,34TOS in the control group was 10,13 ± 1,97. Osteopontin was 6.74 ± 3.45. Fetuin-A was2.40 ± 0.98. OsI was 0,82 ± 0,19.There were not significant differences in TAS value. But there were significant differencesin TOS, fetuin-A, and osteopontin values among the patient groups (p <0.05)Group 1: 22 patients with spina bifida occulta (27,5%): TOS was 13,73 ± 2,75. Osteopontinwas 6.92 ± 3.70. Fetuin-A was 1.2 ± 0.54. OsI was 1.25 ± 0.38.Group 2: 22 patients both with meningomyelocele and meningocele (32,5%): TOS was12,07 ± 3,10. Osteopontin was 3,22 ± 1,68. Fetuin-A was 1,04 ± 0,61. OsI was 1,02 ± 0,30.Group 3: 32 patients with congenital hydrocephaly (40%): TOS was 11,54 ± 3,31.Osteopontin was 4,36 ± 2,12. Fetuin A was 0,87 ± 0,21. OsI was 0.97 ± 0.30.Conclusion: It has been found out that the amount of oxidative stress increases in patientswith OHD. It has been underlined that the greater the oxidative stress values are, the greater thetissue and the organ damages are in infants who were born with OHD. It has been seen that due tothe low OPN values, a reduction in osteoblast activity and tissue damage in the bone matrix occurin patients with OHD. It has also been found out that the lower the fetuin-A values are, the higheris the damages in the nerve tissues.

Giriş ve amaç: Orta Hat kapanma Defekti malformasyonu doğumsal spinal omurgalarınarka bölümlerinin birleşme kusurudur. OHD yüksek morbidite ve mortalite ile ilişkilidir. Buçalışmada OHD'li olan hastalarda total antioksidan ve total oksidan statuslerin, osteopontin vefetuin-A değerleri araştırıldı ve farklı hasta gruplarındaki dağılımı ortaya çıkarıldı. OHDmalformasyonlarının alınan tedbirler ile aile ve toplum içinde azaltılması hedeflendi.Metot: Çalışma Kasım 2015-Nisan 2018 tarihleri arasında Harran Üniversitesi Araştırmave Uygulama Hastanesi Beyin ve Sinir Cerrahi polikliniğine ve kliniğine, Yenidoğan ve ÇocukHastalıkları kliniğine 0-5 yaş grubu arasında grup 1. Spina Bifida Occulta (n=22), grup 2. SpinalMeningosele veya Miyelomeningosele (n=26), grup 3. Hidrosefali (n=31) toplam 80 vaka ile OrtaHat Kapanma Defektleri olmayan 0-5 yaş kontrol grubu olarak 85 vaka, toplam 165 vaka çalışmayaalındı. Muayene sonrası hemogram, kan biyokimya, koagulogram bakıldı. Sonra toplanan kanserum örneklerinde OHD'yi etkileyen sitokinler fetuin-A, osteopontin, total antioksidant status(TAS) ve total oksidan status (TOS) araştırıldı.Bulgular: TAS değeri hariç hasta ve kontrol grupları arasında TOS, Osİ, fetuin-A,osteopontin değerlerinde anlamlı farklılıklar tespit edildi (hepsi için, p<0.05).Vaka grubunda TOS 12,31 ± 3,19. Osteopontin 4,69 ± 2,90. Fetuin A 1,03 ± 0,48. Osİ 1,06± 0,34.Kontrol grup TOS 10,13 ± 1,97. Osteopontin 6,74 ± 3,45. Fetuin A 2,40 ± 0,98. Osİ 0,82± 0,19.Hasta grupları arasında TAS değeri hariç TOS, fetuin-A, osteopontin değerlerinde anlamlıfark tespit edildi (p<0.05).1. grup: 22 hasta spina bifida occulta (%27,5), TOS 13,73±2,75. Osteopontin 6,92±3,70.Fetuin-A 1,2±0,54. Osİ 1,25±0,38.2. grup: 22 hasta meningomiyelosel ve meningosel ile birlikte alındı (%32,5). TOS12,07±3,10. Osteopontin 3,22±1,68. Fetuin-A 1,04±0,61. Osİ 1,02±0,30.3. grup: 32 hasta konjenital hidrosefali (%40). TOS 11,54±3,31. Osteopontin 4,36±2,12.Fetuin A 0,87±0,21. Osİ 0,97±0,30.Sonuç: OHD'li hastalarda oksidatif stresin miktarında artma tespit edildi. Oksidatif stresdeğerleri ne kadar artarsa, doku ve organ hasarına bağlı OHD ile doğan bebeklerdeki malformasyonşiddetinin de o kadar arttığı belirlendi. OHD'li hastalarda OPN değerleri düşüklüğü nedeni ileosteoblast aktivitesinde azalma ve kemik matriksinde doku hasarının oluştuğu görüldü. Fetuin-Adeğerleri ne kadar azalırsa o kadar sinir dokusundaki hasarın yüksek olduğu tespit edildi.