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

Yıl 2014, Cilt: 48 Sayı: 1, 61 - 66, 17.03.2014

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.

Kaynakça

  • Ha KY, Lee JS, Kim KW. Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up. Spine 2008;33:1192-8.
  • Yoshihara H. Sacroiliac joint pain after lumbar/lumbosa- cral fusion: current knowledge. Eur Spine J 2012;21:1788- 96.
  • Maigne JY, Planchon CA. Sacroiliac joint pain after lum- bar fusion. A study with anesthetic blocks. Eur Spine J 2005;14:654-8.
  • DePalma MJ, Ketchum JM, Saullo TR. Etiology of chron- ic low back pain in patients having undergone lumbar fu- sion. Pain Med 2011;12:732-9.
  • Hansen H, Manchikanti L, Simopoulos TT, Christo PJ, Gupta S, Smith HS, et al. A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions. Pain Physician 2012;15:E247-78.
  • Rupert MP, Lee M, Manchikanti L, Datta S, Cohen SP. Evaluation of sacroiliac joint interventions: a systematic ap- praisal of the literature. Pain Physician 2009;12:399-418.
  • Liliang PC, Lu K, Liang CL, Tsai YD, Wang KW, Chen HJ. Sacroiliac joint pain after lumbar and lumbosacral fu- sion: findings using dual sacroiliac joint blocks. Pain Med 2011;12:565-70.
  • Dussault RG, Kaplan PA, Anderson MW. Fluoros- copy-guided sacroiliac joint injections. Radiology 2000;214:273-7.
  • Buenaventura RM, Shah RV, Patel V, Benyamin R, Singh V. Systematic review of discography as a diagnostic test for spinal pain: an update. Pain Physician 2007;10:147-64.
  • Yakut E, Düger T, Oksüz C, Yörükan S, Ureten K, Turan D, et al. Validation of the Turkish version of the Oswes- try Disability Index for patients with low back pain. Spine 2004;29:581-5.
  • Collen FM, Wade DT, Robb GF, Bradshaw CM. The Riv- ermead Mobility Index: a further development of the Riv- ermead Motor Assessment. Int Disabil Stud 1991;13:50-4.
  • Küçükdeveci AA, Tennant A, Elhan AH, Niyazoglu H. Validation of the Turkish version of the Roland-Morris Disability Questionnaire for use in low back pain. Spine 2001;26:2738-43.
  • Ware JE Jr, Sherbourne CD. The MOS 36-item short- form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-83.
  • Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. Re- liability and validity of the Turkish version of the Short Form-36 (SF-36). Ilac Tedavi Derg 1999;12:102-6.
  • Kalaycı Ş. SPSS uygulamalı çok değişkenli istatistik teknikleri. Ankara: Asil Yayın Dağıtım; 2009.
  • Frymoyer JW, Howe J, Kuhlmann D. The long-term ef- fects of spinal fusion on the sacroiliac joints and ilium. Clin Orthop Relat Res 1978;134:196-201.
  • Ebraheim NA, Elgafy H, Semaan HB. Computed tomo- graphic findings in patients with persistent sacroiliac pain after posterior iliac graft harvesting. Spine 2000;25:2047- 51.
  • Katz V, Schofferman J, Reynolds J. The sacroiliac joint: a potential cause of pain after lumbar fusion to the sacrum. J Spinal Disord Tech 2003;16:96-9.
  • Ivanov AA, Kiapour A, Ebraheim NA, Goel V. Lumbar fusion leads to increases in angular motion and stress across sacroiliac joint: a finite element study. Spine 2009;34:E162-9.
  • Chou D, Dekutoski M, Hermsmeyer J, Norvell DC. The treatment of lumbar adjacent segment pathology after a previous lumbar surgery: a systematic review. Spine 2012;37(22 Suppl):180-8.
  • Hawkins J, Schofferman J. Serial therapeutic sacroiliac joint injections: a practice audit. Pain Med 2009;10:850-3.
  • Hart R, Wendsche P, Kočiš J, Komzák M, Okál F, Krejzla J. Injection of anaesthetic-corticosteroid to relieve sacroiliac joint pain after lumbar stabilisation. [Article in Czech] Acta Chir Orthop Traumatol Cech 2011;78:339-42. [Abstract]

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

Yıl 2014, Cilt: 48 Sayı: 1, 61 - 66, 17.03.2014

Öz

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.

Kaynakça

  • Ha KY, Lee JS, Kim KW. Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up. Spine 2008;33:1192-8.
  • Yoshihara H. Sacroiliac joint pain after lumbar/lumbosa- cral fusion: current knowledge. Eur Spine J 2012;21:1788- 96.
  • Maigne JY, Planchon CA. Sacroiliac joint pain after lum- bar fusion. A study with anesthetic blocks. Eur Spine J 2005;14:654-8.
  • DePalma MJ, Ketchum JM, Saullo TR. Etiology of chron- ic low back pain in patients having undergone lumbar fu- sion. Pain Med 2011;12:732-9.
  • Hansen H, Manchikanti L, Simopoulos TT, Christo PJ, Gupta S, Smith HS, et al. A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions. Pain Physician 2012;15:E247-78.
  • Rupert MP, Lee M, Manchikanti L, Datta S, Cohen SP. Evaluation of sacroiliac joint interventions: a systematic ap- praisal of the literature. Pain Physician 2009;12:399-418.
  • Liliang PC, Lu K, Liang CL, Tsai YD, Wang KW, Chen HJ. Sacroiliac joint pain after lumbar and lumbosacral fu- sion: findings using dual sacroiliac joint blocks. Pain Med 2011;12:565-70.
  • Dussault RG, Kaplan PA, Anderson MW. Fluoros- copy-guided sacroiliac joint injections. Radiology 2000;214:273-7.
  • Buenaventura RM, Shah RV, Patel V, Benyamin R, Singh V. Systematic review of discography as a diagnostic test for spinal pain: an update. Pain Physician 2007;10:147-64.
  • Yakut E, Düger T, Oksüz C, Yörükan S, Ureten K, Turan D, et al. Validation of the Turkish version of the Oswes- try Disability Index for patients with low back pain. Spine 2004;29:581-5.
  • Collen FM, Wade DT, Robb GF, Bradshaw CM. The Riv- ermead Mobility Index: a further development of the Riv- ermead Motor Assessment. Int Disabil Stud 1991;13:50-4.
  • Küçükdeveci AA, Tennant A, Elhan AH, Niyazoglu H. Validation of the Turkish version of the Roland-Morris Disability Questionnaire for use in low back pain. Spine 2001;26:2738-43.
  • Ware JE Jr, Sherbourne CD. The MOS 36-item short- form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-83.
  • Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. Re- liability and validity of the Turkish version of the Short Form-36 (SF-36). Ilac Tedavi Derg 1999;12:102-6.
  • Kalaycı Ş. SPSS uygulamalı çok değişkenli istatistik teknikleri. Ankara: Asil Yayın Dağıtım; 2009.
  • Frymoyer JW, Howe J, Kuhlmann D. The long-term ef- fects of spinal fusion on the sacroiliac joints and ilium. Clin Orthop Relat Res 1978;134:196-201.
  • Ebraheim NA, Elgafy H, Semaan HB. Computed tomo- graphic findings in patients with persistent sacroiliac pain after posterior iliac graft harvesting. Spine 2000;25:2047- 51.
  • Katz V, Schofferman J, Reynolds J. The sacroiliac joint: a potential cause of pain after lumbar fusion to the sacrum. J Spinal Disord Tech 2003;16:96-9.
  • Ivanov AA, Kiapour A, Ebraheim NA, Goel V. Lumbar fusion leads to increases in angular motion and stress across sacroiliac joint: a finite element study. Spine 2009;34:E162-9.
  • Chou D, Dekutoski M, Hermsmeyer J, Norvell DC. The treatment of lumbar adjacent segment pathology after a previous lumbar surgery: a systematic review. Spine 2012;37(22 Suppl):180-8.
  • Hawkins J, Schofferman J. Serial therapeutic sacroiliac joint injections: a practice audit. Pain Med 2009;10:850-3.
  • Hart R, Wendsche P, Kočiš J, Komzák M, Okál F, Krejzla J. Injection of anaesthetic-corticosteroid to relieve sacroiliac joint pain after lumbar stabilisation. [Article in Czech] Acta Chir Orthop Traumatol Cech 2011;78:339-42. [Abstract]
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orijinal Makale
Yazarlar

Nihal Buker Bu kişi benim

Semih Akkaya Bu kişi benim

Oguzhan Gokalp Bu kişi benim

Ali Kitis Bu kişi benim

Raziye Savkin Bu kişi benim

A. Esat Kiter Bu kişi benim

Yayımlanma Tarihi 17 Mart 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 48 Sayı: 1

Kaynak Göster

APA Buker, N., Akkaya, S., Gokalp, O., Kitis, A., vd. (2014). Middle-term therapeutic effect of the sacroiliac joint blockade in patients with lumbosacral fusion-related sacroiliac pain. Acta Orthopaedica Et Traumatologica Turcica, 48(1), 61-66.
AMA Buker N, Akkaya S, Gokalp O, Kitis A, Savkin R, Kiter AE. Middle-term therapeutic effect of the sacroiliac joint blockade in patients with lumbosacral fusion-related sacroiliac pain. Acta Orthopaedica et Traumatologica Turcica. Mart 2014;48(1):61-66.
Chicago Buker, Nihal, Semih Akkaya, Oguzhan Gokalp, Ali Kitis, Raziye Savkin, ve A. Esat Kiter. “Middle-Term Therapeutic Effect of the Sacroiliac Joint Blockade in Patients With Lumbosacral Fusion-Related Sacroiliac Pain”. Acta Orthopaedica Et Traumatologica Turcica 48, sy. 1 (Mart 2014): 61-66.
EndNote Buker N, Akkaya S, Gokalp O, Kitis A, Savkin R, Kiter AE (01 Mart 2014) Middle-term therapeutic effect of the sacroiliac joint blockade in patients with lumbosacral fusion-related sacroiliac pain. Acta Orthopaedica et Traumatologica Turcica 48 1 61–66.
IEEE N. Buker, S. Akkaya, O. Gokalp, A. Kitis, R. Savkin, ve A. E. Kiter, “Middle-term therapeutic effect of the sacroiliac joint blockade in patients with lumbosacral fusion-related sacroiliac pain”, Acta Orthopaedica et Traumatologica Turcica, c. 48, sy. 1, ss. 61–66, 2014.
ISNAD Buker, Nihal vd. “Middle-Term Therapeutic Effect of the Sacroiliac Joint Blockade in Patients With Lumbosacral Fusion-Related Sacroiliac Pain”. Acta Orthopaedica et Traumatologica Turcica 48/1 (Mart 2014), 61-66.
JAMA Buker N, Akkaya S, Gokalp O, Kitis A, Savkin R, Kiter AE. Middle-term therapeutic effect of the sacroiliac joint blockade in patients with lumbosacral fusion-related sacroiliac pain. Acta Orthopaedica et Traumatologica Turcica. 2014;48:61–66.
MLA Buker, Nihal vd. “Middle-Term Therapeutic Effect of the Sacroiliac Joint Blockade in Patients With Lumbosacral Fusion-Related Sacroiliac Pain”. Acta Orthopaedica Et Traumatologica Turcica, c. 48, sy. 1, 2014, ss. 61-66.
Vancouver Buker N, Akkaya S, Gokalp O, Kitis A, Savkin R, Kiter AE. Middle-term therapeutic effect of the sacroiliac joint blockade in patients with lumbosacral fusion-related sacroiliac pain. Acta Orthopaedica et Traumatologica Turcica. 2014;48(1):61-6.