Duygu Karaköse ÇALIŞKAN, Alp GURBET, Selcan AKESEN, Yunus Gürkan TÜRKER

Transforaminal epidural steroid enjeksiyonu ile eş zamanlı dorsal kök ganglion üzerine uygulanan darbeli radyofrekans tedavisinin ağrı üzerine palyatif etkisi

Amaç: Kronik lomber radiküler ağrısı olan hastalarda transforaminal epidural steroid enjeksiyonu (TESE) ve darbeli radyofre- kans (DRF)’ın lomber dorsal kök gangliyonuna (DKG) eşzamanlı uygulanmasının ile yalnız başına TESE tedavisi ile karşılaştırıl- ması amaçlanmıştır. Gereç ve Yöntem: Çalışmaya toplam 129 hasta dahil edildi. 67 hastaya TESE, 62 hastaya TESE+ DKG-DRF uygulandı. Demog- rafik veriler, cerrahi müdahaleler ve ilaçların tipleri, işlemin yapıldığı vücut tarafı ve sayısı kaydedildi. Hastalar ameliyat öncesi ve sonrası 10. gün, birinci ve üçüncü ay takip ziyaretlerinde değerlendirildi ve Görsel Analog Skala (VAS, 0–10) ile ağrı skorları değerlendirildi. Üçüncü ay takip vizitlerinde memnuniyet değerlendirmeleri ölçüldü. Başarılı terapötik yanıt, VAS skorlarında %50 veya daha fazla oranda azalma olarak tanımlandı. Bulgular: Her iki grupta postoperatif VAS skorları preoperatif düzeylerden anlamlı olarak düşüktü (p

The effect of combined pulsed radiofrequency treatment to dorsal root ganglion with transforaminal epidural steroid injection on pain

Objectives: We aimed to compare the treatment response with simultaneous application of transforaminal epidural steroid injection (TESI) and pulsed radiofrequency (PRF) to the lumbar dorsal root ganglion (DRG) with TESI in patients with chronic lumbar radicular pain. Methods: A total of 129 patients were enrolled. TESI was performed to 67 patients and TESI+DRG-PRF was performed to 62 patients. Demographic data, surgical records, and medications, side, and level of the procedure were recorded. Patients were evaluated on the pre-operative and post-operative 10th day, 1st and 3rd month follow-up visits, and visual analog scale (VAS, 0–10) scores, and patients’ satisfaction assessment on the 3 rd month follow-up were collected. A successful therapeutic re- sponse was defined as a 50% or more reduction in VAS scores. Results: In both groups, post-operative VAS scores were significantly lower than the pre-operative levels (p˂0.001). VAS scores in the TESI+DRG-PRF group were significantly lower than the TESI group at all follow-up periods (p˂0.001). Reduction ratios in VAS scores were significantly higher in the TESI+DRG-PRF group in all follow-up visits (p˂-0.001). Satisfaction levels were significantly higher in the TESI+DRG-PRF group (p˂0.01). Conclusion: According to our study, TESI provides short-moderate pain relief in patients with chronic lumbar radicular pain. A simultaneous application of PRF in the same session with TESI should be considered as an option to improve the treatment response.

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