Lumbosakral füzyon sonrası gelişen sakroiliak ağrıda sakroiliak eklem blokajının orta vadede terapötik etkisi

Öz

Amaç: Bu çalışmanın amacı lumbosakral füzyonlu hastalar ile füzyonu olmayan hastalarda sakroiliak (SI) blokaj uygulamasının terapötik etkilerini karşılaştırmaktı. Çalışma planı: Blokaj enjeksiyonu (metilprednizolon ve lidokain) ile SI ağrı tanısı almış 72 hasta çalışmaya alındı. Daha önce lumbosakral füzyon öyküsü olan 22 hasta ilk gruba alınırken, füzyonu olmayan 50 hasta ikinci grubu oluşturdu. Hastalar ortalama 17.7 (dağılım: 6-30) ay takip edildiler. Hastalar enjeksiyon öncesinde ve sonrasında Görsel Analog Skala (GAS), Oswestry Özür Anketi, Rivermead Mobilite İndeksi ve SF-36 ile değerlendirildiler. Sonuçların istatistiksel karşılaştırması yapıldı. Bulgular: Sonuçlarda sadece GAS’ın ‘aktivite ağrısı’ bileşeni füzyonsuz grubun lehine anlamlı bir fark gösterdi (p=0.042). Diğer parametreler arasında anlamlı bir fark bulunamadı (p>0.05). Çıkarımlar: Sakroiliak blokaj tedavisinin, orta vadede, lumbosakral füzyonlu hastalarda ameliyat geçirmemiş hastalardakine benzer bir terapötik etkisi olduğunu söyleyebiliriz. Bu nedenle, füzyonlu hasta grubunda farklı bir tedavi alternatifi düşünülmesine gerek yoktur.

Anahtar Kelimeler

• Ağrı; enjeksiyon; lumbosakral füzyon; sakroiliak eklem.

Middle-term therapeutic effect of the sacroiliac joint blockade in patients with lumbosacral fusion-related sacroiliac pain

Abstract

Objective: The aim of this study was to compare the therapeutic effect of sacroiliac (SI) blockade in patients with and without lumbosacral fusion. Methods: This study included 72 patients diagnosed with SI pain and who received blockade injection (methylprednisolone and lidocaine). Patients were divided into 2 groups; 22 patients in the fusion group who underwent previous lumbosacral fusion and 50 patients in the non-fusion group. Average follow-up was 17.7 (range: 6 to 30) months. All patients were evaluated before and after intervention using the Visual Analog Scale (VAS), Oswestry Disability Index, Rivermead Mobility Index and SF-36. Results were statistically analyzed. Results: Activity pain (a component of VAS) was significantly better in the non-fusion group than the fusion group (p=0.042). No other statistically significant differences were observed between groups (p>0.05). Conclusion: Sacroiliac blockade has a similar therapeutic effect on patients who underwent lumbosacral fusion surgery as on non-operated patients in the middle-term. Therefore, alternative treatment options are not necessary in patients with fusion.

Keywords

• Injection
• lumbosacral fusion
• pain
• sacroiliac joint

Kaynakça

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