Person: ŞENCAN, SAVAŞ
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ŞENCAN
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SAVAŞ
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Publication Open Access Pain Relief due to Transsacrococcygeal Ganglion Impar Block in Chronic Coccygodynia: A Pilot Study(OXFORD UNIV PRESS, 2015-07) GÜNDÜZ, OSMAN HAKAN; Gunduz, Osman Hakan; Sencan, Savas; Kenis-Coskun, OzgeObjectiveCoccygodynia is a distressing condition that presents with pain around the coccyx. Impar (Walther) ganglion is a sympathetic ganglion located at the end of lumbosacral sympathetic chain. The objective of this study is to share our results and follow up of 34 ganglion impar blocks in 22 patients. DesignRetrospective pilot study. SettingInterventional Pain Clinic in the Department of Physical Medicine and Rehabilitation in a university hospital. SubjectsTwenty-two patients with coccygodynia who did not respond to conservative treatment and then presented to interventional pain clinic of a PM&R department in a university hospital MethodsPain was evaluated via 10-cm visual analog scale (VAS). VAS values were obtained before, 1 hour and 3 weeks after injection and during this study was conducted. ResultsFor achieving at least 50% relief of pain, the success rate of a first injection was 82%, but accounted for three technical failures. In patients with a successful outcome, relief lasted for a median duration of 6 months. Relief was reinstated for a median period of 17 months by a second injection in nine patients who presented for repeat treatment. No relief was achieved in two of these patients when they presented for a third treatment. ConclusionsGanglion impar block appears to be effective in patients who have coccygodynia resistant to conservative therapy, with high success rates and prolonged duration of effect. Controlled studies are required to reveal the mechanism of this effect.Publication Open Access Reply to the Letter by J. Hambraeus, 'Ganglion Impar Blocks for More than Coccygodynia'(OXFORD UNIV PRESS, 2016-03-15) GÜNDÜZ, OSMAN HAKAN; Gunduz, Osman Hakan; Sencan, Savas; Kenis-Coskun, OzgePublication Open Access Does obesity have an impact on the radiation exposure_x000D_ during lumbosacral transforaminal epidural steroid_x000D_ injections? Retrospective study(2019) GÜNDÜZ, OSMAN HAKAN; Savaş SENCAN;Esra GİRAY;Fırat ULUTATAR;Osman Hakan GÜNDÜZAim: To find out whether obesity or injection level have an impact on the amount of radiation exposure during fluoroscopy-guidedlumbosacral transforaminal epidural steroid injections (TFESIs).Material and Methods: Patients aged 19-65 years who underwent lumbosacral transforaminal epidural steroid injection wereretrospectively reviewed. Eighty-three patients with a mean age of 42.7±13.2 (19-65) years with signs and symptoms of unilaterallumbar radicular pain due to single level disc herniation were included. Subjects were categorized as normal weighted (18.5≤bodymass index (BMI) ≤ 24.9), overweighed (25≤BMI<30) and obese (BMI≥30) according to World Health Organization BMI criteria. Allpatients were given unilateral TFESIs, including39 (47%) L5, and 44 (53%) S1 level. Radiation exposure dose and procedure time wasautomatically measured by fluoroscope.Results: Radiation dosage increased significantly with increasing BMI (p=0.0001). No statistically significant differenceswere found when three groups’ procedure durations and NRS scores were compared (>0.05). The radiation dosages andprocedure durations between the two different injection levels (L5 and S1) were not found to be statistically significant (>0.05).Conclusion: Obesity is associated with increased radiation exposure independent of procedure duration and the injection level.Publication Open Access Efficacy of epidural steroid injection in elderly patients: does diagnosis affect treatment success(2023-01-01) SAÇAKLIDIR, REKİB; ŞENCAN, SAVAŞ; Olgun Y., SAÇAKLIDIR R., Okumus Y., ŞENCAN S., Guenduez O. H.Introduction: Epidural steroid injections are a preferred interventional pain treatment for patients with low back pain. Our aim was to investigate the effectiveness of epidural steroid injections treatment in elderly patients and to examine the effect of patients\" diagnosis on the treatment success.Materials and Methods: Patients over the age of 65 who underwent epidural injections between January 2020 and January 2022 were retrospectively screened. The patients were divided into three groups according to their diagnosis: disc herniation, spinal stenosis, and failed back surgery syndrome. Numeric rating scale scores of all patients before the procedure, at three weeks, and at three months were noted.Results: A total of 234 patients were included in the study. Of these, 89 had disc herniation, 98 had spinal stenosis, and 47 had a history of failed back surgery. There were no significant differences between the groups in terms of age, gender, symptom duration, pre-procedural pain score, medical treatment, radiation dose, and procedure duration. Although a significant improvement was detected in pain scores at all follow-ups in all groups, these scores were found to be significantly lower in the disc herniation group than the spinal stenosis and failed back surgery groups at the three-week and month follow-ups.Conclusions: Epidural steroid injections has been found to be effective in back pain in elderly. In addition, elderly patients with disc herniation had a better response to treatment than those with spinal stenosis and failed back surgery. Further prospective and long-term follow-up studies are needed to support these results.Publication Open Access Do informative leaflets affect pre-procedural anxiety and immediate pain after transforaminal epidural steroid injections? A prospective randomized controlled study(KARE PUBL, 2020) GÜNDÜZ, OSMAN HAKAN; Ozdemir, Yeliz Bahar; Sencan, Savas; Ercalik, Tulay; Kokar, Serdar; Gunduz, Osman HakanObjectives: The aim of this study was to evaluate the effect of an informative leaflet provided to patients before a lumbar transforaminal epidural steroid injection (TFESI) on the level of immediate pain and pre-procedural anxiety. Methods: A total of 166 patients were randomized into 2 groups: a group that received an explanatory leaflet (LG) and a control group. Both groups were given verbal information, while the LG was also given an illustrated leaflet describing the injection process. All of the patients were evaluated with the Hospital Anxiety and Depression Scale before the TFESI. The numerical rating scale and the Oswestry Disability Index (ODI) were used to assess disability and pain before and after the TFESI. Major complications that occurred before and during the procedure were recorded and analyzed. Results: The patient characteristics were similar in both groups (age, body mass index, depression level, pre-procedural pain, and ODI). The anxiety level was also similar in both groups (p>0.05). When both groups were evaluated at the first hour after the procedure, the numerical rating scale level of pain intensity was also similar (p>0.05). No major complication was observed in either group. Conclusion: The detailed leaflet did not affect the patients' pre-procedural anxiety or acute post-procedural pain level. However, the importance of informed consent and comprehensive information should not be overlooked.Publication Open Access The effect of central sensitization on interlaminar epidural steroid injection treatment outcomes in patients with cervical disc herniation: an observational study(2022-09-01) SAÇAKLIDIR, REKİB; ŞANAL TOPRAK, CANAN; GÜNDÜZ, OSMAN HAKAN; ŞENCAN, SAVAŞ; Sacaklidir R., ŞANAL TOPRAK C., Yucel F. N. , GÜNDÜZ O. H. , ŞENCAN S.© 2022, American Society of Interventional Pain Physicians. All rights reserved.Background: Central sensitization (CS) is a hyperexcitability that is manifested by the increased response of the central nervous system to sensory stimuli. It has been shown that the presence of CS may have a negative effect on the clinical picture in some musculoskeletal diseases and also have a negative effect on spinal procedures. Objectives: To investigate the effect of CS on interlaminar epidural steroid injection (ILESI) treatment outcomes in patients with cervical disc herniation (CDH). Study Design: An observational study. Setting: A university hospital pain management center. Methods: Patients, who underwent ILESI between 2020-2021 due to CDH, were included in the study. The Numeric Rating Scale (NRS-11), Neck Pain and Disability Scale (NPDS), Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), and Short Form-12 (SF-12) were used for evaluation of patients. Patients were assessed before the procedure, at the first hour, and 3 months after the procedure. The presence of CS was investigated by the Central Sensitization Inventory (CSI). Results: A total of 51 patients were included in the study. Twenty-three of the patients had CS, as assessed by the CSI. Although, patients who underwent ESI, had significantly lower NRS-11, S-LANSS, and NPDS scores, and higher SF-12 scores at all follow-up points. The first and third months, NRS-11, S-LANSS, and NPDS were significantly higher, and SF-12 scores were lower in the CS group compared to patients without CS. Limitations: The short follow-up period and relatively low number of patients can be considered as a limitation. The fact that CS is not evaluated with a more objective method, such as Quantitative Sensory Testing (QST), can be considered as another limitation. Since most clinicians use CSI, so from a \"real world\" perspective the lack of QST may be observed as a strength of the study. The third limitation is that we did not evaluate the patients’ pre-and posttreatment analgesic consumption. Finally, we did not include patients with a history of psychiatric illness, but not evaluating the current psychiatric conditions of the patients could be considered a limitation. Nevertheless, the main strengths of this study are its prospective design and, to our knowledge, it is the first study to explore the effects of CS on cervical ESI treatment. Conclusions: The presence of CS has a negative effect on pain scores, disability, and quality of life in patients undergoing cervical ESI due to CDH.Publication Open Access Rare complication of ganglion impar blockade with the transsacrococcygeal approach: A case of rectal perforation(2022-06-01) OKÇU, MEHMET; ŞENCAN, SAVAŞ; GÜNDÜZ, OSMAN HAKAN; OKÇU M., ŞENCAN S., GÜNDÜZ O. H.Although it has been reported that caution should be exercised in terms of rectal perforation, as the ganglion impar is located just behind the rectum in the presacral space, the authors could not find any case or images of rectal perforation occurring during ganglion impar blockade in the literature. In this report, the case of a 38-year-old female with rectal perforation that developed during ganglion impar blockade, performed by the transsacrococcygeal approach under fluoroscopy guidance, is presented. Wrong needle selection and the structurally short presacral space of the patient may have influenced the development of rectal perforation in the patient. This study presents the first case and images of rectal perforation in the literature that developed during the application of ganglion impar blockade using the transsacrococcygeal technique. In ganglion impar block applications, technically appropriate needles should be used, and care should be taken in terms of rectal perforation.Publication Metadata only Does facet tropism negatively affect the response to transforaminal epidural steroid injections? A prospective clinical study(SPRINGER, 2019) GÜNDÜZ, OSMAN HAKAN; Celenlioglu, Alp Eren; Sencan, Savas; Gunduz, Osman HakanObjectiveTo examine the impact of the presence of facet tropism on the results of transforaminal epidural steroid injection for unilateral radicular pain induced by lumbar disc herniation.Materials and MethodsWe included 112 patients diagnosed with unilateral, single-level lumbar disc herniation-induced radicular pain. Injection was planned at relevant levels. The patients were assessed using the Numerical Rating Scale, the Modified Oswestry Disability Index, and the Beck Depression Inventory before the injection and at hour 1, week 3, and month 3 after the injection. Presence of facet tropism was assessed by measuring the facet angles in the L3-4, L4-5, and L5-S1 segments of lumbar MRI T2 sequence axial section.ResultsA significant decrease in the Numerical Rating Scale and an increase in the Modified Oswestry Disability Index scores were detected at all follow-ups in groups comprising 39 patients with and 61 without facet tropism (p<0.05). On comparison, improvement in clinical parameters at week 3 and month 3 in the group without facet tropism was greater (p<0.05). As treatment success is considered to be a 50% reduction in the Numerical Rating Scale scores, 55.2% of the patients attained treatment success at month 3. Further, although the treatment success rate in the group with facet tropism was 34.2%, it was 69% in that without facet tropism (p<0.05).ConclusionFacet tropism correlates with less success of transforaminal epidural steroid injection; therefore, facet tropism may be a worthwhile measurement in a discussion with patients of the benefits of the procedure.Publication Open Access Cervical Radiculopathy Impact Scale: Translation, cross-cultural adaptation, reliability and validity of the Turkish version(2022-12-01) ŞENCAN, SAVAŞ; SAÇAKLIDIR, REKİB; ÖZTÜRK, EKİM CAN; GÜNDÜZ, OSMAN HAKAN; Çelenlioğlu A. E. , ŞENCAN S., Saçaklıdır R., ÖZTÜRK E. C. , GÜNDÜZ O. H.© 2022 Turkish League Against Rheumatism. All rights reserved.Objectives: The aim of this study was to translate and cross-culturally adapt the English version of the Cervical Radiculopathy Impact Scale (CRIS) and to investigate the validity and reliability of the Turkish version of the CRIS. Patients and methods: Between October 2021 and February 2022, a total of 105 patients (48 males, 57 females; mean age: 45.4±11.8 years; range, 36.5 to 55.5 years) who were diagnosed with cervical radiculopathy due to disc herniation were included. Disability and quality of life were evaluated with the Neck Disability Index (NDI), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), and Short Form-12 (SF-12). Pain severity was evaluated using the Numerical Rating Scale (NRS) in three subscales (neck pain, pain radiating to the arm, and numbness in the finger, hand, or arm). The internal consistency for CRIS was assessed using the Cronbach alpha and test-retest reliability by intraclass correlation coefficients (ICCs). Explanatory factor analyses were performed for construct validity. To examine the content validity, the correlations among the three subgroup scores of CRIS and the other scale scores were analyzed. Results: The internal consistency of CRIS was found to be high (α=0.937). A high reliability was obtained for test-retest reliability for the three subscales of CRIS (Symptoms, Energy and postures, Actions and activities) (ICC: 0.950, 0.941, 0.962, respectively; p<0.001). All three subscale scores of CRIS were correlated with the NDI, QuickDASH, SF-12 (physical and mental) and NRS scores (r=0.358-0.713, p<0.001). Factor analysis showed that the scale had five factors. Conclusion: The CRIS is a valid and reliable instrument for Turkish patients with cervical radiculopathy due to disc herniation.Publication Open Access Effect of sacralization on the success of lumbar transforaminal epidural steroid injection treatment: prospective clinical trial(2022-06-01) ŞENCAN, SAVAŞ; BİLİM, SERHAD; GÜNDÜZ, OSMAN HAKAN; ŞENCAN S., Azizov S., Celenlioglu A. E., Bilim S., GÜNDÜZ O. H.Objective The aim of this study was to invastigate the efect of the sacralization on the results of transforaminal epidural steroid injection for radicular low back pain. Materials and methods The study included 64 patients diagnosed with radicular low back pain due to unilateral and singlelevel lumbar disk herniation. Patients were divided into 2 groups: patients with sacralization (Group S) and patients without lumbosacral transitional vertebrae (Group A). Injection was applied to the relevant level. Patients were evaluated with Numeric Rating Scale and Modifed Oswestry Disability Index before, at week 3 and month 3 after the procedure. Sacralization presence was determined by MRI. Sacralization was categorized by anteroposterior lumbar radiography using Castellvi classifcation. Treatment success was considered as≥50% reduction in NRS scores. Results Numeric Rating Scale and Modifed Oswestry Disability Index scores decreased in both groups on both week 3 and month 3 (p<0.05). Pain scores of Group S (median value 5 (3–6)) were signifcantly higher than Group A ((median value 3 (0–5)) in the third month follow-up (p=0.026), but no signifcant diference was observed at other time points. There was no signifcant diference in Modifed Oswestry Disability Index scores between the groups at all follow-ups (p>0.05). Treatment success in the third month was 44.8% in Group S and 65.6% in Group A. Conclusion Transforaminal epidural steroid injection is an efective and safe method for radicular low back pain. Sacralization presence should be evaluated before treatment considering that it may be a risk factor reducing treatment success.