Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Comparison of Transforaminal and Interlaminar Epidural Steroid Injection in Managing Lumbar Radiculopathy(2017) Rahatli, Feride Kural; Harman, Ali; Boyvat, Fatih; Zararsiz, Gokmen; https://orcid.org/0000-0002-4226-4034; https://orcid.org/0000-0002-7386-7110; AAL-9808-2021; K-9824-2013; F-4230-2011Purpose: Epidural steroid injection is a commonly used low risky symptomatic treatment option of lumbar radiculopathy in patients with poor response to conservative management. The purpose of this prospective study was to compare the efficacy of transforaminal and interlaminar epidural steroid injection. Materials and methods: In this study computed tomography guided lumbar epidural steroid injections were performed in 87 patients, steroid injections were made by transforaminal and interlaminar technique. The effectiveness of this treatment was evaluated by visual analogue scale at 2 weeks ( acute), 3 months (sub-acute) and 6 months ( chronic) after the injection. Results: In interlaminar group 78.1% patients had effective pain relief at acute term and 73.4% patients had effective pain relief at sub-acute and chronic term. In transforaminal group 82.6% patients had effective pain relief at acute term and 73.9% patients had effective pain relief at sub-acute and chronic term. Transforaminal group showed slightly better pain relief in all terms but the difference was not statistically significant. Patients with symptom duration more than 6 months had statistically significant higher pain relief than the patients with symptom duration less than 6 months in acute term but there was no statistically significant difference between sub-acute and chronic terms. Conclusion: In the current study transforaminal epidural steroid injections for the treatment of lumbar radiculopathy resulted in better pain relief than interlaminar epidural steroid injections in all terms but the difference was not statistically significant.Item The Effectiveness of Computed Tomography-Guided Lumbar Epidural Steroid Injections for Spinal Pain Management: A Single Center Experience with 2-Year Follow-Up(2017) Harman, Ali; Duman, Enes; Ozdemir, Adnan; 0000-0002-7386-7110; 0000-0001-5221-1879; K-9824-2013; K-4333-2018Purpose: To determine the therapeutic value and long-term effects of Computed Tomography (CT)-guided translaminar and transforaminal lumbar epidural steroid injections for spinal pain management. Materials and methods: Between December 2011 and June 2013, 428 CT-guided epidural steroid injections of the lumbar spine for 310 patients were assessed retrospectively. There were 325 Translaminar (TL) (in 225 patients) and 103 Transforaminal (TF) (in 85 patients) injections performed. The clinical effectiveness of the injection after the therapy was assessed using Visual Analog Scale (VAS). The patients were classified into three groups (A-C) after injections according to the reduction in the VAS's. Results: Technical success rate of 100% without any major complication related to needle placement or drug administration. There were 27 (6.3%) reported minor complications (n: 3 orthostatic hypotension (0.7%) and n: 24 transient motor weaknesses of lower extremities (5.6%). The mean visual analog scores before and after the injections were recorded as 8.9 +/- 1.1 and 4.8 +/- 2.5 retrospectively (p 0.001). In 23 of 310 patients epidural injections were repeated in different times during study and 73 epidural injections (n: 61 TL and n: 12 TF) were performed. Conclusion: CT guided epidural injection in the lumbar spine is safe, repeatable and efficacious pain management technique. Both translaminar and transforaminal epidural steroid injections can provide reliable pain relief for up to average 5.5 and 5.6 months respectively.