Lomber Disk Hernisine Bağlı Radikülopatili Hastalarda Floroskopi Eşlikli LomberTransforaminalEpidural Enjeksiyonun Etkinliği

Amaç: Lomber disk hernisine bağlı radikülopatili hastalarda lomber transforaminal epidural enjeksiyonun (TFEE) etkinliğinin araştırılması. Yöntemler: TFEE yapılan ve çalışma kriterlerini karşılayan 80 hasta retrospektif olarak incelendi. Tüm hastalara aynı yöntem ile C-kollu floroskopi eşliğinde, radikülopatinin olduğu taraf ve seviyeye, radyoopak madde ile hedeflenen foramen teyit edildikten sonra 40 mg metilprednisolon asetat ve 20 mg bupivacaine karışımı enjekte edildi. İşlem öncesi görsel analog skala (VAS) değerleri, işlem sonrası 3. saat, işlem sonrası 1. ay ve işlem sonrası 3. ay VAS değerleri ile karşılaştırıldı.VAS değerlerindeki azalma 0-%24,9, %25-49,9, %50-74,9 ve ≥%75 şeklinde sınıflandırıldı. Üçüncü ayın sonundaki VAS değerlerinde işlem öncesine göre en az % 50 azalma olan olgularda işlem başarılı kabul edildi. Ayrıca işlem başarısı ile yaş, cinsiyet, vücut kitle indeksi (VKİ) ve semptom süresi arasındaki ilişki değerlendirildi. Bulgular: Toplam 80 olgu arasından, 65 olguda (%81,3) işlem başarılı olurken, 15 olguda (%18,7) ise işlem başarısız olmuştur. Semptom süresi 6 aydan kısa olan olgularda başarı oranı % 80 iken, semptom süresi 6 ay ve daha uzun olan olguların başarı % 20 olarak saptanmıştır (p

The effectiveness of Fluoroscopy-guided Transformational Epidural Injection in Radiculopathy Secondary to Lumbar Disc Herniations

Objective: To analyze the effectiveness of transforaminal epidural injection (TFEI) in patients with radiculopathy secondary to lumbar disc herniations. Method: Eighty patients undergoing TFEI and meeting study criteria were analyzed retrospectively. A mixture of 40 mg of methylprednisolone acetate and 20 mg of bupivacaine was injected to the site and the level of the radiculopathy after confirmation of the targeted foramen with radiopaque agent under C-armed fleuroscopic guidance. Pre-injection visual analogue scale (VAS) values were compared to the post-injection, 1-month post-injection and 3-month postinjection VAS values. Reduction in VAS values were grouped as 0-%24.9, 25-49.9%, 50-74.9%, >75%. The procedure was considered successful when at least 50% of VAS reduction is achieved at the end of the 3rd month of the procedure compared to the pre-injection VAS value. Association between age, sex, body mass index (BMI), symptom duration and success of the procedure was also evaluated. Results: Of the total of 80 patients, success was achieved in 65 patients (81.3%) whereas 15 patients (18.7%) failed. Success rate was 80% in patients with symptom duration of 6 months. No significant association was found between age, sex, level, side, BMI and success rate of the procedure. The general reduction of VAS was 84% at the third hour of injection, 71.9% at the 1st month of injection and 65.5% at the 3rd month of injection. Conclusions: TFEI is an effective procedure for mid-term pain control in the patients with radiculopathy secondary to lumbar disc herniations when a careful patient selection is provided. Effectiveness of the procedure relatively decreases in the patients with a symptom duration of more than 6 months.

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