Burhanettin USTA, Bünyamin MUSLU, Rüveyda İrem DEMİRCİOĞLU, Hüseyin SERT, Muhammet GÖZDEMİR, Safinaz KARABAYIRLI

Semptomatik disk hernilerinde servikal epidural steroid uygulaması

Amaç: Servikal radikülopati toplumda yaygın olup, tedavisinde kullanılan yöntemler konservatif tedaviden cerrahi tedaviye kadar geniş bir aralıkta yer almaktadır. Optimal radiküler ağrı tedavisinde invaziv yaklaşımlar açısından henüz tam bir fikir birliği bulunmamaktadır. Servikal diskopati semptomları gösteren hastalarda servikal epidural steroid injeksiyonu (SESİ) bu tedavi yaklaşımlarından birisidir. Gereç ve Yöntem: Bir yıllık dönem içerisinde semptomatik servikal radikülopati tanısı almış 58 hastaya uygulanan SESİ tedavisinin 6 aylık dönemdeki sonuçları geriye dönük olarak incelendi. Hastalar oturur ve baş fleksiyon pozisyonda iken standart sterilizasyon sonrası C7-T1 aralığından median yaklaşım ve asılı damla tekniği kullanılarak epidural aralığa girildi ve daha önceden hazırlanan, içerisinde 80 mg triamsinolon ile 10 mg levobupivakainin bulunduğu 6 mllik solüsyon enjekte edildi. Bulgular: SESİ uygulaması sonrası hastaların vizüel analog skala (VAS) değerlerinin tedavi öncesi değerlere göre anlamlı olarak daha düşük bulundu. SESİ tedavisinde başarı oranları 1., 3. ve 6. ayda sırasıyla %93, %86 ve %72 idi. Sonuç: SESİ uygulaması servikal radikülopati tedavisinde etkili bir yöntemdir ve hastaların cerrahiye ihtiyaç duyma oranlarını düşürmektedir.

Cervical epidural steroid injections for symptomatic disc herniations

Objectives: Cervical radiculopathy is widespread in society, and the methods used in the treatment cover a wide range from conservative treatment to surgical treatment. There is not yet a full consensus on the use of invasive approaches for the optimal treatment of radicular pain. However, cervical epidural steroid injection (CESI) has been used in patients with symptoms of cervical discopathy. Methods: Results of the six-month period of treatment of 58 patients, diagnosed as symptomatic cervical radiculopathy with application of CESI within a one-year period, were evaluated retrospectively. With the patients in a sitting position and with the head flexed, the epidural space was accessed from the C7-T1 aperture using the median approach and the hanging drop technique, and a preprepared 6 ml solution consisting of 80 mg triamcinolone with 10 mg levobupivacaine was injected following standard sterilization. Results: The post-CESI treatment VAS values of the patients were significantly lower than pretreatment VAS values. The treatment success rates for CESI application were 93% in the 1st month, 86% in the 3rd month, and 72% in the 6th month, respectively. Conclusion: The CESI application is an effective method in the treatment of cervical radiculopathy and reduces the rate of patients needing surgery.

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