Guclu Bulent, Deniz Levent, Yuce Yucel, Adilay Utku, Aytar Hamit, Turkoglu Meryem, Tiryaki Mehmet, Ozdek Recep, Boran Burak Orhan
Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey.
Turk Neurosurg. 2020;30(3):394-399. doi: 10.5137/1019-5149.JTN.27220-19.3.
To compare the effect of fluoroscopically guided transforaminal epidural steroid injections on radicular pain in foraminal and paramedian lumbar disc herniations.
This study included patients who did not benefit from previous medical treatments or are not suitable for surgery. Transforaminal epidural steroid injections for the treatment of foraminal and paramedian lumbar disc herniation were performed in 370 and 1262 patients, respectively. Every group’s preprocedural visual analogue scale (VAS) and 12-week postprocedural VAS scores were recorded, and statistical analysis was performed. The complications noted were also recorded.
The preprocedural and postprocedural mean VAS scores for radicular pain in foraminal disc herniation were 67.11 ± 4.28 and 34.78 ± 3.64, respectively. However, the preprocedural and postprocedural mean VAS scores in paramedian disc herniation were 62.16 ± 6.65 and 19.07 ± 4.50, respectively. Statistical analysis of the varying preprocedural and postprocedural VAS scores showed that transforaminal epidural steroid injections were more effective for paramedian disc herniation than for foraminal disc herniation (p < 0.05).
Transforaminal epidural steroid injections were more effective for paramedian lumbar disc herniation than for foraminal disc herniation, 12 weeks after the procedure.
比较在X线透视引导下经椎间孔硬膜外注射类固醇对椎间孔型和旁中央型腰椎间盘突出症所致神经根性疼痛的疗效。
本研究纳入了此前的药物治疗无效或不适合手术的患者。分别对370例椎间孔型腰椎间盘突出症患者和1262例旁中央型腰椎间盘突出症患者进行了经椎间孔硬膜外注射类固醇治疗。记录每组术前视觉模拟评分(VAS)和术后12周的VAS评分,并进行统计分析。同时记录观察到的并发症。
椎间孔型椎间盘突出症患者术前和术后神经根性疼痛的平均VAS评分分别为67.11±4.28和34.78±3.64。然而,旁中央型椎间盘突出症患者术前和术后的平均VAS评分分别为62.16±6.65和19.07±4.50。对术前和术后不同的VAS评分进行统计分析显示,经椎间孔硬膜外注射类固醇治疗旁中央型椎间盘突出症比治疗椎间孔型椎间盘突出症更有效(p<0.05)。
术后12周时,经椎间孔硬膜外注射类固醇治疗旁中央型腰椎间盘突出症比治疗椎间孔型腰椎间盘突出症更有效。