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Comparison of Caudal Versus Transforaminal Epidural Steroid Injection in Post Lumbar Surgery Syndrome After Single-level Discectomy: A Prospective, Randomized Trial

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dc.contributor.authorŞENCAN, SAVAŞ
dc.contributor.authorGÜNDÜZ, OSMAN HAKAN
dc.contributor.authorsCelenlioglu A. E., ŞENCAN S., Bilim S., Sancar M., GÜNDÜZ O. H.
dc.date.accessioned2023-04-10T12:36:34Z
dc.date.available2023-04-10T12:36:34Z
dc.date.issued2022-03-01
dc.description.abstractBackground: Epidural fibrosis (EF) is one of the leading causes of post lumbar surgery syndrome (PLSS). Although there are studies in the literature suggesting that lumbar epidural steroid injections are an effective method in the pain management of PLSS caused by EF, no study is available comparing the effectiveness and safety of caudal and transforaminal approaches. Objectives: To investigate the efficacy of caudal epidural steroid injection (CESI) versus transforaminal epidural steroid injection (TFESI) in patients with PLSS. Study Design: A prospective, randomized, assessor-blind study. Setting: Interventional pain management center at a tertiary care center. Methods: Patients with low back and radicular pain related to EF following single-level lumbar discectomy were included. The patients were randomly divided into 2 groups: a CESI group and a TFESI group. All patients were assessed before the procedure (baseline) and at one hour, 3 weeks, and 3 months after the procedure using the Numeric Rating Scale (NRS-11) and at baseline, 3 weeks, and 3 months using the modified Oswestry Disability Index (mODI). Treatment success was defined as a ≥ 50% decrease in the NRS-11 scores compared to baseline. Results: A total of 56 patients (n = 26 CESI group; n = 30 TFESI group) were included. NRS-11 and mODI scores showed a significant decline in both groups at all follow-ups (P < 0.001). At 3 weeks, the improvement in the mODI scores was significantly higher in the TFESI group (P = 0.020). In all follow-ups, the NRS-11 scores were similar between the groups. At 3 weeks, the rates of patients with a ≥ 50% decrease in NRS-11 scores were 53.8% and 60% in the CESI group and TFESI group, respectively, while these rates were 30% and 26.7%, respectively, at 3 months. Limitations: This study had no placebo-control group and a relatively short follow-up. Conclusion: Both CESI and TFESI are effective and safe methods in the treatment of PLSS caused by EF following lumbar discectomy. These methods can reduce pain and disability. Although both methods have similar treatment success rates, TFESI seems to be a more effective treatment method in reducing disability at 3-week follow-up. Keywords: Post lumbar surgery syndrome, failed back surgery syndrome, post laminectomy syndrome, epidural fibrosis, epidural steroid injections, transforaminal, caudal, radiculopathy, back pain
dc.identifier.citationCelenlioglu A. E., ŞENCAN S., Bilim S., Sancar M., GÜNDÜZ O. H., "Comparison of Caudal Versus Transforaminal Epidural Steroid Injection in Post Lumbar Surgery Syndrome After Single-level Discectomy: A Prospective, Randomized Trial", PAIN PHYSICIAN, cilt.25, sa.2, ss.161-169, 2022
dc.identifier.endpage169
dc.identifier.issn1533-3159
dc.identifier.issue2
dc.identifier.startpage161
dc.identifier.urihttps://hdl.handle.net/11424/288554
dc.identifier.volume25
dc.language.isoeng
dc.relation.ispartofPAIN PHYSICIAN
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectTıp
dc.subjectSağlık Bilimleri
dc.subjectDahili Tıp Bilimleri
dc.subjectNöroloji
dc.subjectCerrahi Tıp Bilimleri
dc.subjectAnesteziyoloji
dc.subjectMedicine
dc.subjectHealth Sciences
dc.subjectInternal Medicine Sciences
dc.subjectNeurology
dc.subjectSurgery Medicine Sciences
dc.subjectAnesthesiology
dc.subjectANESTEZİYOLOJİ
dc.subjectKlinik Tıp
dc.subjectKlinik Tıp (MED)
dc.subjectKLİNİK NÖROLOJİ
dc.subjectANESTHESIOLOGY
dc.subjectCLINICAL MEDICINE
dc.subjectClinical Medicine (MED)
dc.subjectCLINICAL NEUROLOGY
dc.subjectNeurology (clinical)
dc.subjectAnesthesiology and Pain Medicine
dc.subjectLife Sciences
dc.subjectPost lumbar surgery syndrome
dc.subjectfailed back surgery syndrome
dc.subjectpost laminectomy syndrome
dc.subjectepidural fibrosis
dc.subjectepidural steroid injections
dc.subjecttransforaminal
dc.subjectcaudal
dc.subjectradiculopathy
dc.subjectback pain
dc.subjectFAILED BACK SURGERY
dc.subjectPERCUTANEOUS ADHESIOLYSIS
dc.subjectCLINICAL EFFECTIVENESS
dc.subjectSPINAL STENOSIS
dc.subjectDISC HERNIATION
dc.subjectRADICULAR PAIN
dc.subjectDOUBLE-BLIND
dc.subjectCOMPLICATIONS
dc.subjectMANAGEMENT
dc.titleComparison of Caudal Versus Transforaminal Epidural Steroid Injection in Post Lumbar Surgery Syndrome After Single-level Discectomy: A Prospective, Randomized Trial
dc.typearticle
dspace.entity.typePublication
local.avesis.id663a1a4c-1c11-4b74-a4f3-b4337841d84a
local.indexed.atWOS
local.indexed.atPUBMED
local.indexed.atSCOPUS
relation.isAuthorOfPublication0541c742-2e3a-46ec-8370-0a7e705cf536
relation.isAuthorOfPublication99eab134-696e-4f08-ad55-8a621e9cc6c2
relation.isAuthorOfPublication.latestForDiscovery0541c742-2e3a-46ec-8370-0a7e705cf536

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