ORIJINAL ARAŞTIRMA
Lomber Epidural Enjeksiyon Uygulanan Hastalarda Sinir Kökü Sedimantasyon İşareti ve Beyin Omurilik Sıvısı Sinyal Kaybı Belirtisinin Tedavi Başarısı ile İlişkisi
The Relationship between Nerve Root Sedimentation Sign and Cerebrospinal Fluid Signal Loss Sign with Treatment Success in Patients Undergoing Lumbar Epidural Injections
Received Date : 31 May 2023
Accepted Date : 25 Jun 2023
Available Online : 07 Jul 2023
Samet Sancar KAYAa
aDepartment of Pain Medicine, Adıyaman University Training and Research Hospital, Adıyaman, Türkiye
Doi: 10.31609/jpmrs.2023-98257 - Makale Dili: EN
J PMR Sci. 2023;26(3):321-7
ÖZET
Amaç: Sinir kökü sedimantasyon işareti (SKSİ) ve beyin omurilik
sıvısı sinyal kaybı işaretinin (BOSSK), lomber spinal stenoz (LSS) tedavisinde
interlaminar lumbar epidural steroid enjeksiyonlarının (İLESE) kısa
vadeli sonuçlarını tahmin edip edemeyeceğini belirlemek. Gereç ve Yöntemler:
Bu retrospektif çalışmaya LSS tanısı alan ve İLESE uygulanan toplam
73 hasta dâhil edildi. Başarılı ağrı yönetimi, İLESE’den bir ay sonra
vizüel analog skala skorunda ≥%50 azalma olarak belirlendi. Hastalar başarılı
ve başarısız olarak iki gruba ayrıldı. SKSİ ve CFSLS iki grup arasında
karşılaştırıldı. Bulgular: Başarılı gruptaki hastaların %62,2’sinde, başarısız
gruptaki hastaların ise %32,1’inde SKSİ pozitifti ve gruplar arasında
SKSİ varlığı açısından istatistiksel olarak anlamlı fark vardı (p=0,017). Başarılı
gruptaki hastaların %62,2’sinde, başarısız gruptaki hastaların ise
%57,11’inde BOSSK pozitifti ve BOSSK pozitifliğine göre gruplar arasında
istatistiksel fark yoktu (p=0,806). Sonuç: İLESE’den bir ay sonra pozitif
SKSİ’li hastalarda negatif SKSİ’li hastalara göre bel/bacak ağrısı daha fazla
azaldı. SKSİ, LSS’li hastalarda İLESE tedavisinin kısa süreli başarısını öngörmede
değerli bir işaret olabilir.
Anahtar Kelimeler: Lomber spinal stenoz; sedimantasyon işareti; serebrospinal sıvı sinyali; interlaminar epidural steroid enjeksiyonu
ABSTRACT
Objective: This study aimed to determine whether nerve root
sedimentation sign (NRSS) and cerebrospinal fluid signal loss sign (CFSLS)
could predict the short-term outcomes of interlaminar lumbar epidural
steroid injections (ILESIs) in the treatment of lumbar spinal stenosis (LSS).
Material and Methods: In this retrospective study, a total of 73 patients
who were diagnosed with LSS and underwent ILESIs were included. Successful
pain management was determined as a decrease of ≥50% in visual
analogue scale scores 1 month after ILESIs. The patients were divided into
successful and unsuccessful treatment groups and the findings of NRSS and
CFSLS were compared between the two groups. Results: While 62.2% of
patients in the successful group had a positive NRSS, 32.1% of patients in
the unsuccessful group had a positive NRSS and the difference was statistically
significant (p=0.017). The CFSLS was positive for 62.2% of patients
in the successful group compared to 57.11% of patients in the unsuccessful
group and this difference was not statistically significant (p=0.806). Conclusion:
One month after ILESI, low back/leg pain decreased more in patients
with positive NRSS than in patients with negative NRSS. The NRSS
might be a valuable sign in predicting the success of ILESI treatment among
patients with LSS.
Keywords: Lumbar spinal stenosis; sedimentation sign; cerebrospinal fluid signal; interlaminar epidural steroid injection
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