ANIL PASWAN, AMRITA RATH, Reena, Gauresh SINGH

Lomber Radiküler Ağrı Tedavisinde Kambin Üçgeni Yaklaşımı ile Uygulanan Steroid Enjeksiyonunun Etkinliğinin Konvansiyonel Transforaminal Yaklaşımla Karşılaştırılması: Prospektif Randomize Çalışma

Amaç: Bel ağrısı, yaş ve cinsiyetten bağımsız olarak yaygın görülen bir problemdir. Hastalar için zahmetli bir süreç olan bu durumun konservatif olarak tedavisi çok zordur. Bu patoloji, hastalarda hareket kısıtlılığı ve mental problemlere yol açabilir. Yöntem: Prospektif, randomize, çift-kör olarak planlanan çalışma etik kurul onayından sonra gerçekleştirildi. Lomber radiküler ağrısı olan 20-70 yaş arası 40 hasta konvansiyonel transforaminal ve Kambin üçgeni yaklaşımı olmak üzere iki farklı gruba ayrılarak epidural steroid uygulandı. Sözlü Sayısal Derecelendirme Ölçeği kullanılarak ağrı şiddetindeki değişiklik primer sonuç olarak kaydedildi. Oswestry Engellilik İndeksi ve Hasta Memnuniyet Skoru kullanılarak fonksiyonel durumdaki değişiklikler ikincil sonuç olarak kaydedildi. İşlem sırasında karşılaşılan advers olaylar, komplikasyonlar ve işlemin başarısız olduğu hastalar kaydedildi. Bulgular: Yaş, cinsiyet, lezyonun lokalizasyonu ve yaklaşım yönteminde, ağrının giderilmesi ve fonksiyonel durumdaki iyileşme açısından gruplar arasında istatistiksel olarak anlamlı fark saptanmadı. Sonuç: Transforaminal epidural steroid enjeksiyonu için kullanılan her iki yaklaşım da ağrıyı azaltmada ve fonksiyonel durumu düzeltmede anlamlı şekilde etkiliydi ve her iki yöntemin de etkinliği benzer bulundu. Etkililiklerinde önemli bir fark yoktu ve hiçbiri diğerinden üstün değildi.

A Comparative Study of the Effectiveness of Lumbar Steroid Injection in Kambin’s Triangle Versus Conventional Transforaminal Approach for the Treatment of Lumbar Radicular Pain: A Prospective Randomised Study

Objective: Low back pain is a very troublesome and common issue among patients irrespective of age and sex and is very difficult to manage with conservative management. It can lead to disability and mental issues. Methods: After ethical committee approval, a prospective, randomised, double-blind comparative study on 40 patients aged 20-70 years, suffering from lumbar radicular pain was carried out by two different approaches i.e., conventional transforaminal and Kambin’s triangle approach and epidural steroids were administered. Change in pain intensity using the Verbal Numerical Rating Scale was recorded as our primary outcome. Change in functional status using Oswestry Disability Index and Patient Satisfaction Score were our secondary outcomes. Any adverse event, complication, failure was also noted. Results: Multiple logistic regression showed no difference in pain relief or improvement of functional status due to variable differences like the age, sex, disc level or the type of approach. Conclusion: Both approaches of transforaminal epidural steroid injection were effective in reducing pain and increasing functional status significantly. There was no significant difference in their effectiveness and neither was superior to the other

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