Person: KOKAR, SERDAR
Loading...
Email Address
Birth Date
Research Projects
Organizational Units
Job Title
Last Name
KOKAR
First Name
SERDAR
Name
4 results
Search Results
Now showing 1 - 4 of 4
Publication Open Access Fluoroscopic confirmation of needle location in ultrasound-guided genicular nerve radiofrequency thermocoagulation(2023-10-01) KOKAR, SERDAR; Polat O. E., KOKAR S.BACKGROUND: Radiofrequency thermocoagulation of genicular nerves is an effective treatment for chronic pain due to knee osteoarthritis. The procedure can be performed under fluoroscopic or ultrasonographic guidance. OBJECTIVES: The aim of this study was to fluoroscopically check the final location of the needle in ultrasound-guided genicular nerve radiofrequency thermocoagulation and evaluate the treatment\"s success in patients with knee pain. STUDY DESIGN: A 2-center, prospective study. SETTING: A private clinic and a tertiary care health center. METHODS: Thirty-two patients who had unilateral knee pain, and grade 3-4 knee osteoarthritis according to the Kellgren-Lawrence classification were included. Following diagnostic genicular nerve blocks in patients whose knee pain was relieved by >= 50%, radiofrequency thermocoagulation was applied to these nerves. The final position of the needle was checked via fluoroscopy in anteroposterior and lateral planes. RESULTS: The needle was located in the one-third anterior portion of the bone shaft in 69 of 96 patients (71.9%), between one-third and two-thirds in 21 (21.9%), and in the one-third posterior portion in 6 (6.3%). The mean Numeric Rating Scale score for pain was 7.69 ± 0.99 before treatment, 4.03 ± 1.26 at one week, 2.53 ± 1.24 at one month, and 2.19 ± 1.71 at 3 months, indicating a statistically significant decrease (P < 0.001). LIMITATIONS: The lack of a study group in which genicular nerve radiofrequency thermocoagulation was performed under fluoroscopy guidance could be cited among the limitations of this clinical study. CONCLUSIONS: The final position of the needle tip in radiofrequency thermocoagulation of genicular nerves can exist at the one-third anterior of the bone shaft, without a need for further advancing the needle to the posterior portion. Although performed more distally compared to fluoroscopy guidance, ultrasound-guided genicular nerve radiofrequency thermocoagulation still provides effective analgesia.Publication Open Access Predictive factors for treatment success of epidural steroid injections in patients with lumbar spinal surgery(2023-10-01) KOKAR, SERDAR; GÜNDÜZ, OSMAN HAKAN; KOKAR S., Sacaklidir R., Olgun Y., Sencan S., GÜNDÜZ O. H.OBJECTIVE: The efficacy of epidural steroid injections (ESIs) in the treatment of radicular pain in patients undergoing lumbar spinal surgery is still unclear. The aim of this study was to investigate the factors affecting the success of ESIs in the treatment of ongoing radicular pain in patients undergoing lumbar spinal surgery. PATIENTS AND METHODS: This study was designed as a single-center, retrospective study, and was conducted at a Pain Management Center of a tertiary care center. A total of 260 patients with failed back surgery syndrome who received fluoroscopy-guided lumbar ESI were included. Treatment success was defined as ≥50% reduction in the numeric rating scale score at the one-month follow-up. The patients were divided into the treatment success and the treatment failure groups. RESULTS: The presence of spinal instrumentation was significantly lower in the treatment success group (p=0.045). Symptom duration and the numeric rating scale score at 1 hour were significantly lower in the treatment success group (p<0.05). The use of triamcinolone acetonide in the treatment success group was found to be significantly higher than in the treatment failure group (p=0.027). CONCLUSIONS: The short duration of symptoms and the absence of instrumentation seem to be prognostic factors that positively affect the success of ESI treatment in operated patients. A ≥50% pain reduction in the first hour after the procedure is a valuable indicator that treatment success can be achieved in the short term. Finally, the steroid type can also affect the treatment results.Publication Open Access Intravenous methylprednisolone as a transition treatment in red ear syndrome: A case report(2023-10-01) KOKAR, SERDAR; Kokar S., UYGUNOĞLU U.Red ear syndrome (RES) is a rare condition of unknown etiology characterized by episodic attacks of unilateral ear pain, redness, and burning sensation. A 31-year-old male patient was admitted to our clinic with a severe headache reaching up to 5 h, presenting with short bursts of electric shock-like sensation, burning, and tingling in the left side of his face. The patient was unresponsive to previous medical treatments. Lidocaine 10% through the intranasal route for sphenopalatine ganglion and stellate ganglion blockade under the guidance of fluoroscopy also failed. Given that the Red-Ear syndrome shares similar pathophysiological pathways with trigeminal autonomic cephalalgias, the patient was treated with high-dose intravenous methylprednisolone, and since then, he has been symptom-free for 6 months. High-dose steroid therapy might be a good alternative in late-onset RES as a transition treatment.Publication Open Access Comment on \"Effectiveness of Radiofrequency Ablation of the Genicular Nerves of the Knee for the Management of Intractable Pain from Knee Osteoarthritis\"(2024-09-01) ŞENCAN, SAVAŞ; KOKAR, SERDAR; GÜNDÜZ, OSMAN HAKAN; Dogan N. H., ŞENCAN S., KOKAR S., GÜNDÜZ O. H.We read with great interest the article by Lee et al (1) titled “Effectiveness of radiofrequency ablation of the genicular nerves of the knee for the management of intractable pain from knee osteoarthritis”. In the light of current literature, the article is found to be noteworthy. There is a remarkable emphasis on the choice of blocking the genicular nerves for control of pain originating from the anterior part of the knee joint. The treatment response depends primarily on the correct localization of pain. Therefore, decision making on selecting genicular nerves as target, requires individualized approaches when genicular nerves thought to be responsible for the knee pain, which is consistent with a recent study (2). However, we would like to address some potential concerns particularly about study design and statistical analysis. The section titled “Patients” contains complex phrases about the nature of the study (prospective/retrospective) and informed consent that needs to be clarified. The definition of ≥ 50% pain reduction in pain intensity from baseline value at 6 months after the treatment as a successful treatment outcome is not reused in the rest of the text. The basis of classification of patients into 2 groups with numeric rating scale (NRS) 6 or NRS ≥ 7 should be explained. A research determining cut-off points on NRS in patients with chronic musculoskeletal pain showed that NRS scores ≤ 5 correspond to mild, scores of 6–7 to moderate and scores ≥ 8 to severe pain, and that cut-off points are affected by catastrophizing tendency (3). Also, comparing of groups containing one value and multiple values may lead to bias. There is a semi-quantitative scoring tool for knee osteoarthritis called MRI Osteoarthritis Knee Score (MOAKS) by Hunter et al (4). It would have been more practical to use MOAKS instead of developing a new MRI grading system that consists of the same criteria except for subchondral cyst. And considering that not every patient with knee osteoarthritis has a magnetic resonance imaging, radiographic correlation with Kellgren-Lawrence scale could have contributed more. There is a discrepancy in the number of cases. In Tables 2 and 3, the total number of cases in the rows “Hyaline cartilage defect tibia (P)” is 53, but the total sample size is stated to be 50. Most importantly, the lack of regression analysis and limited results about within/ between group variation over time, require review of statistical analysis.