Oğuz KARAEMİNOĞULLARI, Orçun ŞAHİN, Fatih BOYVAT, Rahmi Can AKGÜN, Utku GÜRÜN, Hüseyin DEMİRRÖRS, İsmail Cengiz TUNCAY, Reha Nevzat TANDOĞAN

Lumbosakral radiküler ağrı tedavisinde bilgisayarlı tomografi eşliğinde transforaminal epidural steroid enjeksiyonu

Amaç: Bilgisayarlı tomografi (BT) eşliğinde uygulanan transforaminal epidural steroid enjeksiyonlarının, spinal stenoza bağlı lumbosakral radiküler ağrısı olan hastalar üzerindeki etkinliği araştırıldı. Çalışma planı: Spinal stenoza bağlı lumbosakral radiküler ağrısı olan 42 hasta (7 erkek, 35 kadın; ort. yaş 67; dağılım 34-90) BT eşliğinde uygulanan transforaminal epidural steroid enjeksiyonu sonrası prospektif olarak izlendi. işlem iki hastaya (%4.8) iki kez, bir hastaya (%2.4) ise üç kez uygulandı. Radiküler ağrının şiddeti işlem öncesinde ve işlem sonrası birinci gün, birinci hafta, üçüncü hafta, altıncı ay ve son kontrollerde görsel analog skala (GAS) ile değerlendirildi. Hastaların ortalama takip süresi 12.1 aydı (dağılım 6-25 ay). Sonuçlar: Tedavi öncesi ortanca GAS skoru 9 (dağılım 6-10) bulundu. ilk altı aylık takip sırasında ortanca GAS skorları, tüm değerlendirmelerde tedavi öncesine göre anlamlı derecede düşük bulundu (p

Anahtar Kelimeler:

İleriye dönük çalışma, Radikülopati, Enjeksiyon, epidural, Lumbosakral bölge, Tomografi, x-ışınlı bilgisayarlı, Spinal stenoz, Ağrı ölçümü, Analjezi, epidural, Steroidler

Transforaminal epidural steroid injection under computed tomography guidance in relieving lumbosacral radicular pain

Objectives: We analyzed the efficacy of transforaminal epidural steroid injections under computed tomography (CT) in relieving lumbosacral radicular pain due to spinal stenosis. Methods: Forty-two patients (7 males, 35 females; mean age 67 years; range 34 to 90 years) with lumbosacral radicular pain due to spinal stenosis were prospectively monitored following transforaminal epidural steroid injections under computed tomography. Injections were repeated twice in two patients (4.8%) and three times in one patient (2.4%). The severity of pain was assessed with the use of a visual analog scale (VAS) before and after injections (1st day, 1st week, 3rd week, 6th month, and the last follow-up). The mean follow-up period was 12.1 months (range 6 to 25 months). Results: The median VAS score before injections was 9 (range 6 to 10). During the first six months, the median VAS scores were always significantly lower than the preinjection score (p<0.005). The mean VAS score of 23 patients with a follow-up of at least a year was still significantly lower than that obtained at the end of six months (2.26 vs 2.52, p<0.005). No procedure-related complications occurred. Conclusion: Selective transforaminal epidural steroid and analgesic injection under CT guidance is a safe and reliable conservative method to relieve lumbosacral radicular pain due to spinal stenosis.

Keywords:

Prospective Studies, Radiculopathy, Injections, Epidural, Lumbosacral Region, Tomography, X-Ray Computed, Spinal Stenosis, Pain Measurement, Analgesia, Epidural, Steroids,

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