FLUOROSCOPICALLY GUIDED COMBINED CAUDAL EPIDURAL AND TRANSFORAMINAL INJECTIONS: CAN LONG-TERM PAIN RELIEF BE ACHIEVED WITH A SYNERGISTIC EFFECT?


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Daldal I., Şenköylü A., Arık A., Baymurat A. C., Kurtoğlu A.

XIV ULUSLARARASI TÜRK OMURGA KONGRESİ, İzmir, Türkiye, 25 - 27 Mayıs 2022, ss.450-451

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: İzmir
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.450-451
  • Gazi Üniversitesi Adresli: Evet

Özet

Introduction: Caudal epidural injections and lumbar transforaminal injections of local anesthetic with steroid provided effective and significant improvement to relieve pain originating from degenerative spine disorders like as spinal stenoses and neural foraminal stenoses or disk herniations. With these injection methods, the drugs are directly deliver into the target space to relieve pain. In general, the short-term results of these injections are reported to be good and excellent, but there is ongoing debate about the mid-term and long-term results. In this study, it was aimed to evaluate the short and long-term efficacy of combined epidural caudal and transforaminal epidural injections in degenerative lumbar spine patients over 60 years of age with low back and radicular pain. Methods: Between 2017 and 2019, 105 patients over the age of 60 who had spinal stenosis with radicular symptoms and had at least 2 years of follow-up were included in the study. Visual analogue scala (VAS) and Oswestry disability index (ODI) were measured pre-injection, 1, 3, 6, 12 and 24 months after the intervention. Results: The VAS and ODI at each observation point of the post-operation were significantly decreased compared with the pre-injection (P<0.05). Although an increase was observed in VAS and ODI scores in the long term (12th and 24th months), it was observed that they remained significantly lower compared to the pre-injection period (P<0.05). Sacral insufficiency fracture that was not detected in the first MRI image was observed in four of the seven patients with increased post-injection pain in the 6th month control magnetic resonance imaging (MRI). Conclusion: Fluoroscopically guided combined transforaminal and caudal epidural steroid injections offered a safe, minimally invasive option for managing pain caused by degenerative spine disorders like as spinal stenosis and neural foraminal stenosis.