Person: SAÇAKLIDIR, REKİB
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SAÇAKLIDIR
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REKİB
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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 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 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 YouTube as a source of information on sacroiliac joint injection: A reliability and quality analysis(2023-03-17) ÖZTÜRK, EKİM CAN; SAÇAKLIDIR, REKİB; ŞENCAN, SAVAŞ; GÜNDÜZ, OSMAN HAKAN; ÖZTÜRK E. C., Yilmaz H., SAÇAKLIDIR R., ŞENCAN S., GÜNDÜZ O. H.Sacroiliac joint (SIJ) injection is recommended for both diagnosis and relief of SIJ pain. YouTube has become a widely used source for health professionals and patients to obtain information about various procedures but the quality of YouTube videos including medical content is questionable. Therefore, the aim of this study is to evaluate the quality of SIJ injection videos on YouTube. This cross-sectional study was conducted through March 2022 by searching the phrase \"sacroiliac joint injection\"on YouTube. After resetting search history top 100 videos were screened. Duration of videos, number of views, number of likes, number of comments, view ratio (number of views/d), time passed since upload date, guide used for injection, and source of videos were recorded. The DISCERN and the Global Quality Scale were used to assess the quality and reliability of the videos. Of the 100 videos screened 42 videos met the inclusion criteria. The videos (73.8%) were predominantly uploaded by physicians. Most frequently used guide for injections was ultrasound with 45.4%. According to the DISCERN classification, 35.7% of the videos were \"very poor,\"30.9% were \"poor,\"21.4% were \"fair,\"7.1% were \"good\"and 4.7% were \"excellent.\"Physicians and patients should be aware of that many of the videos about SIJ injections are categorized as \"poor\"or \"very poor,\"which means they may mislead trainees, resulting in inadequate treatments.Publication Open Access The effect of lumbar multifidus cross-sectional areas on transforaminal epidural steroid injection: An observational clinical study(2023-10-01) SAÇAKLIDIR, REKİB; SOYDEMİR, EFE; ŞENCAN, SAVAŞ; GÜNDÜZ, OSMAN HAKAN; SAÇAKLIDIR R., SOYDEMİR E., ŞENCAN S., GÜNDÜZ O. H.OBJECTIVES: Multifidus has an important role in spinal stability, and multifidus degeneration causes long-term disability and low back pain. This study aimed to investigate the effect of multifidus cross-sectional area on transforaminal epidural steroid injections (TFESI). METHODS: Patients with single-level disc herniation were included in the study. Total multifidus cross-sectional area (TM-CSA) and functional cross-sectional area (FM-CSA) were measured from axial T2 MRI of the patients, and FM-CSA/TM-CSA ratio was calculated for determination of muscle degeneration or fat infiltration. Numerical Rating Scale (NRS) scores at the pre-injection, 3rd week, and 3rd month visits were recorded. A decrease of 50% or more in the NRS score in the 3rd month was accepted as a treatment success (TS), and patients were divided into TS and treatment failure groups. RESULTS: A total of 120 patients were included in the study; 57 of the patients were female, and 63 of them were male. Of the patients included in the study, 68 had herniation at the L5-S1 disc level and 52 had herniation at the L4-L5 disc level. FM-CSA and FM-CSA/TM-CSA ratio were found to be significantly lower below the disc herniation level on the affected side (p<0.05). The affected side TM-CSA and FM-CSA were higher in the TS group and TM-CSA/FM-CSA ratios were equal in both groups. CONCLUSION: Multifidus CSA was found to be lower on the affected side. However, the effect of multifidus CSA on the success of TFESI has not been determined.