Lomber Dorsal Kök Ganglion Pulsed Radyofrekans ve Transforaminal Steroid Enjeksiyonu Sonrasında Nadir Gözlenen Bir Komplikasyon: Hıçkırık

Öz

Epidural steroid enjeksiyonları, özellikle lomber disk hernisi ve radiküler ağrı durumlarında, ağrı tedavisinde sıkça kullanılmaktadır. Genellikle güvenli olmalarına rağmen, nadir komplikasyonlar zaman zaman ortaya çıkabilmektedir. Kronik radiküler ağrısı olan ve konservatif tedaviye yanıt vermeyen 43 yaşındaki erkek hasta, L4-L5 ve L5-S1 seviyelerine dorsal kök ganglion pulsed radyofrekans (DRG-PRF) ve ardından transforaminal steroid enjeksiyonu (TFESI) ile tedavi edilmiştir. İşlemden yaklaşık 20 saat sonra başlayan ve 48 saat süren, uykusunu bölecek şiddette inatçı hıçkırık gelişmiştir. Yapılan takip değerlendirmelerinde nörolojik veya sistemik herhangi bir patoloji saptanmamış; semptomlar medikal müdahale olmadan kendiliğinden gerilemiştir. Epidural enjeksiyon sonrası hıçkırık nadiren rapor edilmekle birlikte, göz ardı edilen bir komplikasyon olabilir. Klinik pratikte, kortikosteroidlere bağlı santral etkiler, epidural basınç değişimleri ya da otonom sinir sistemi dengesizlikleri olası mekanizmalar olarak değerlendirilmelidir. Bu olgu, bu tür atipik komplikasyonlara yönelik farkındalığın artırılması gerektiğini vurgulamaktadır.

Anahtar Kelimeler

• Hıçkırık
• Bel ağrısı
• Epidural enjeksiyon
• Betametazon

Hiccup as a Rare Complication Following Lomber Dorsal Root Ganglion Pulsed Radiofrequency and Transforaminal Steroid Injection

Öz

Epidural steroid injections are frequently used in pain management, particularly in cases of lumbar disc herniation and radicular pain. Although generally safe, rare complications can occasionally arise.A 43-year-old male patient with chronic radicular pain unresponsive to conservative treatment was treated with dorsal root ganglion pulsed radiofrequency (DRG-PRF) followed by transforaminal steroid injection (TFESI) at the L4-L5 and L5-S1 levels. Approximately 20 hours after the procedure, the patient developed persistent hiccups lasting for 48 hours, severe enough to disrupt sleep. No neurological or systemic abnormalities were detected on follow-up evaluations. The symptoms resolved spontaneously without medical intervention.Although hiccups are rarely reported following epidural injections, they may be under-recognized. In clinical practice, it is important to consider corticosteroid-induced central effects, volume-related epidural pressure changes, or autonomic imbalance as possible mechanisms. This case highlights the need for awareness of such atypical complications.

Anahtar Kelimeler

• Hiccups
• Low back pain
• Epidural injection
• Betamethasone

Kaynakça

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