Kronik radiküler semptomlu lumbosakral ağrılı, non-opere hastalarda partiküllü ve partikülsüz steroid uygulaması etkinliğinin retrospektif olarak karşılaştırılması

AYŞEGÜL GÜVEN

Kronik radiküler semptomlu lumbosakral ağrılı, non-opere hastalarda partiküllü ve partikülsüz steroid uygulaması etkinliğinin retrospektif olarak karşılaştırılması

Thesis Type: Expertise In Medicine

Institution Of The Thesis: Ankara University, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Turkey

Approval Date: 2020

Thesis Language: Turkish

Student: AYŞEGÜL GÜVEN

Supervisor: GÜNGÖR ENVER ÖZGENCİL

Open Archive Collection: AVESIS Open Access Collection

Abstract:

In our study, patients with and without particulate and non-operated chronic lumbalgia and fluoroscopic imaging were evaluated retrospectively. In the 1st and 3rd months after the procedure, the clinical changes of the patients were measured with PCIG (Patient Global Impression of change), the general change monitoring, the functional capacities were measured by ODI (oswestry disability index), and the pain scores were used using VAS (visual pain scoring). Afterwards, these data were evaluated and compared. The data in our study were obtained in accordance with the pain tracking forms and electronic information of 130 patients aged 18 and over. The clinical features of the patients in this study were those who had a VAS score of > 4 at admission, who had at least 3 months of lumbalgia and radiculopathy, who had partial benefit from previous medical treatments and did not undergosurgery. Transforaminal epidural steroid injection procedure was applied to patients meeting these features.The statistical significance of the data obtained was used to look at theeffect of thegroup variable on the quantitative variable with repeated measures such as theStudent-t test, Mann Whitney U test, Chi-square, Fisher-exact tests, and the effect of groups of particulate and non-particulatesteroids. P > 0.05 was meaning less, P <0.05 was considered significant. There was no statistically significant difference between the two groups in terms of VAS values at the 1st and 3rd month according to the VAS-0 values in the TFESE patients compared with the particle and non-particle steroid groups (p = 0.060, p = 0.667). When comparing the painchange according to the groups, the ODI-0 (p = 0.013) and ODI-3 (p = 0.034) measurements compared with the non –particle group were statistically significant when the ODI values at the 1st and 3rd months were compared. A statistically significant difference was found by using Generalized Linear Models whether there is a difference between the Particulate and Non-Particulate Steroid types in terms of the trend of the initial, 56 1st and 3rd month repeated measurements of the ODI variable (p = 0.039). Comparing the lumbar TFESE use of particulate and non-particulate steroids, it is stil controversial considering the available literature. Considering the limitedness and duration of data we have obtained, it has been demonsrated that particulate steroids are superior in reducing the pain in terms of short-term efficacy compared to nonparticulate steroids, and long-term results that non-particulate steroids provide advantages.