Is Less Surgical Treatment Possible in the Treatment of Degenerative Spine Diseases? Four-Year Follow-up Results of Foraminal Epidural and Facet Joint Injection Treatments
Öz
Aim
The study aims to examine the long-term outcomes of foraminal epidural injection and facet joint injection therapies in patients over the age of 60 who have been recommended for surgical intervention for degenerative spinal diseases but have declined surgical treatment due to comorbidities, anesthesia risks, and surgical risks.
Methods
Between 2018-2019, patients over the age of 60 diagnosed with Degenerative Spinal Disease who declined the recommended surgical treatment and underwent foraminal epidural and facet joint injection therapies were retrospectively evaluated. Patients were assessed using the visual pain scale and MacNab classifications during an average follow-up period of 57.14 (45-68) months. Inclusion criteria for the study included patients being continuously followed up and treated at the same center, regularly attending check-up examinations, and not having emergency surgical indications.
Results
The study included 35 patients with an average follow-up period of 57.14 months. Patients were treated with either facet joint or foraminal epidural injections in a single session based on their symptoms and complaints. The most striking result of our study is that the visual pain scale and MacNab classification outcomes after spinal injection therapy can be used as indicators for long-term results.
Conclusion
Sharing the outcomes of commonly practiced spinal injection therapies in the literature more frequently will provide guidance for the treatment planning of challenging conditions, especially like degenerative spinal disease.
Anahtar Kelimeler
Kaynakça
- McPhee B, Swanson CE. The surgical management of degenerative lumbar scoliosis: posterior instrumentation alone versus two stage surgery. Bull Hosp Joint Dis. 1998; 57(1):16–22.
- Grubb SA, Lipscomb HJ, Coonrad RV. Degenerative adult onset scoliosis. Spine 1988;13(3):241–45.
- Hanley1 EN Jr. The indication for lumbar spinal fusion with and without instrumentation. Spine 1995; 20 (24):143–53
- Benner B, Ehni G. Degenerative lumbar scoliosis. Spine 1979; 4(6):548–52.
- Daffner SD, Vaccaro AR. Adult degenerative lumbar scoliosis. Am J Orthop 2003; 32(2):77–82.
- Teichtahl AJ, Urquhart DM, Wang Y, Wluka AE, Wijethilake P, O'Sullivan R et al. Fat infiltration of paraspinal muscles is associated with low back pain, disability, and structural abnormalities in community-based adults. Spine J. 2015; 15, 1593–601.
- Kim WJ, Shin HM, Lee JS, Song DG, Lee JW, Chang SH, et al. Sarcopenia and Back Muscle Degeneration as Risk Factors for Degenerative Adult Spinal Deformity with Sagittal Imbalance and Degenerative Spinal Disease: A Comparative Study. World Neurosurg. 2021, 148, 547–55.
- Hiyama A, Katoh H, Sakai D, Tanaka M, Sato M, Watanabe M. The correlation analysis between sagittal alignment and cross-sectional area of paraspinal muscle in patients with lumbar spinal stenosis and degenerative spondylolisthesis. BMC Musculoskelet. Disord. 2019; 20, 352.
- Ploumis A, Transfledt EE, Denis F. Degenerative lumbar scoliosis associated with spinal stenosis. Spine J 2007; 7 :428–36.
- Tribus CB. Degenerative lumbar scoliosis: evaluation and management. J Am Acad Orthop Surg 2003; 11:174–83.