Mehmet Fatih ÇETİN, Haktan KARAMAN, Gönül KAVAK ÖLMEZ, Adnan TÜFEK, Zeynep YILDIRIM BAYSAL

Lumbar radikülopatili hastalarda transforaminal lumbar epidural steroid enjeksiyonlarının etkinliği

Amaç: Bu çalışmada, lumbar disk hernisine bağlı radikülopatisi olan hastalara uygulanan transforaminal lumbar epidural steroid enjeksiyonun (TLESE) etkinliği ve güvenliği araştırıldı. Gereç ve Yöntem: Çalışma TLESE uygulanan hastaların dosyalarının retrospektif olarak taranması ile hazırlandı. En az bir aydır devam eden, konservatif tedaviye yanıt vermeyen, görüntüleme yöntemlerinde bulging ya da protrüzyonu olan lumbar disk hernili hastalar çalışmaya dahil edildi. Bütün uygulamalar C-kollu foroskopi eşliğinde, lokal anestezi altında ve ayaktan metotla uygulandı. Tüm olgularda 80 mg triamsinolon ve %0.25lik bupivakain karışımı, disk hernisinin olduğu düzeyden, transforaminal olarak, anterior epidural bölgeye enjekte edildi. Başlangıç VAS ağrı skorları değerleri, uygulama sonrası 1., 3. ve 6. ay değerleri ile karşılaştırıldı. Uygulamaya yönelik hasta memnuniyeti, puanlanarak tespit edildi. Ayrıca erken ve geç dönem komplikasyonları değerlendirme için toplandı. Bulgular: Toplam 222 hastaya 460 kez TLESE uygulanmıştır (ortalama: 2.1, tekrarlanma aralığı: 1-6 kez). Uygulamalar en sık L4-L5 ve L5-S1 düzeylerinden gerçekleştirilmiştir. Başlangıç VAS skorları ortalaması 8.2±0.7 iken, TLESE sonrası 1., 3. ve 6. ayda sırasıyla 5.0±1.6, 4.8±1.5 ve 5.1±1.5 olarak bulunmuştur. Hastaların %63.9u (n=142) memnuniyetlerini iyi ve mükemmel olarak belirtmişlerdir. Majör komplikasyonun yaşanmadığı bu çalışmada toplam minör komplikasyon oranı %11.1dir. Sonuç: TLESEnin kısa ve orta dönemde etkin ve güvenli bir yöntem olduğu görülmüştür.

Efficacy of transforaminal lumbar epidural steroid injections in patients with lumbar radiculopathy

Objectives: Tis study looks into the efcacy and safety of the transforaminal lumbar epidural steroid injection (TLESI) applied to patients with radiculopathy due to lumbar disk herniation. Methods: Te patients fles which were applied TLESI, were retrospectively scanned. Patients who did not respond to one-month conservative treatment and who were detected to have bulging or protruding lumbar disk herniation as a result of imaging methods were included in the study. All applications were performed with C-arm fuoroscopy under local anesthesia by outpatient method. In all cases, a mix of 80 mg triamsinolone and 0.25% bupivacaine, was transforaminally injected to the anterior epidural area. Initial VAS pain scores were compared with the values of the 1, 3 and 6th months after the application. Patient satisfaction was determined through scoring. Furthermore, early and late term complications were collected for evaluation. Results: A total of 222 patients were administered TLESI 460 times (average: 2.1, repeat interval: 1-6 times). Te applications were carried out most frequently at the levels of L4-L5 and L5-S1. While the initial VAS score average was 8.2±0.7, after TLESI, it was 5.0±1.6, 4.8±1.5 and 5.1±1.5 in the 1, 3 and 6th months, respectively. 63.9% of the patients (n=142) defned the treatment as good and excellent. No major complications were experienced and the overall minor complication rate was 11.1%. Conclusion: It was seen that TLESI was an efcient and safe method in the short and medium term.

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