Konservatif Tedaviye Dirençli Omuz Ağrısının Tedavisinde Supraskapular Sinir Bloğu ve Kombine Subakromiyal Eklem İçi Enjeksiyonlarının Etkinliğinin Karşılaştırılması

Öz

Amaç: Bu çalışmanın amacı, konservatif tedaviye yanıt vermeyen kronik omuz ağrısı olan hastalarda uygulanan supraskapular sinir bloğu (SSSB) ile subakromiyal + intraartiküler (SAI + IAI) enjeksiyon kombinasyonunun etkinliğini karşılaştırmaktır. Materyal ve metod: Bu retrospektif çalışmaya, 2022-2024 yılları arasında algoloji kliniğinde girişimsel ağrı tedavisi uygulanan ve takip kriterlerini karşılayan toplam 114 hasta dahil edilmiştir. Hastalar, tedavi tipine göre SSSB (n=54) ve SAI + IAI enjeksiyon (n=60) olmak üzere iki gruba ayrılmıştır. Ağrı düzeyi visual analog skala (VAS), fonksiyonel durum Shoulder Pain and Disability Index (SPADI) ve yaşam kalitesi Short Form-36 (SF-36) ölçekleri kullanılarak tedavi öncesi, 2. hafta, 3. ay ve 6. ayda değerlendirilmiştir. Bulgular: Her iki grupta da tedavi sonrası tüm zaman noktalarında (2. hafta, 3. ay, 6. ay) VAS, SPADI ve SF-36 skorlarında istatistiksel olarak anlamlı düzeyde iyileşme gözlenmiştir (p<0,001). Bu iyileşmenin 6. aya kadar devam ettiği saptanmıştır. Gruplar arasında iyileşme büyüklüğü açısından istatistiksel olarak anlamlı fark bulunmamıştır (p>0,05). Sonuç: SSSB ve SAI + IAI kombinasyonu, konservatif tedaviye dirençli kronik omuz ağrısında benzer klinik etkinliğe sahiptir. Ancak daha az invazif olan SSSB, uygulama kolaylığı ve hasta konforu yönünden ön plana çıkmakta, etkisinin 6 aya kadar sürdüğü gözlemlenmektedir. Bu nedenle SSSB, tek başına etkili bir girişimsel tedavi seçeneği olarak değerlendirilebilir.

Anahtar Kelimeler

• Omuz ağrısı
• Supraskapuler sinir
• Eklem içi enjeksiyon
• SPADI

Comparison of the Effectiveness of Suprascapular Nerve Block and Combined Subacromial-Intra-articular Injections in the Management of Shoulder Pain Refractory to Conservative Treatment

Öz

Background: The aim of this study was to compare the efficacy of suprascapular nerve block (SSSB) with the combination of subacromial + intraarticular (SAI + IAI) injection in patients with chronic shoulder pain refractory to conservative treatment. Materials and Methods: This retrospective study included a total of 114 patients who received interventional pain management at the Pain Medicine Clinic between 2022 and 2024 and met the follow-up criteria. The patients were allocated into two groups based on the type of treatment administered: SSSB, n=54 and combined subacromial and intra-articular injection (SAI + IAI, n=60). Pain intensity was assessed using the visual analog scale (VAS), functional status was evaluated with the Shoulder Pain and Disability Index (SPADI), and quality of life was measured through the Short Form-36 (SF-36) at baseline, 2 weeks, 3 months, and 6 months post-treatment. Results: In both groups, statistically significant improvements were observed in VAS, SPADI and SF-36 scores at all post-treatment time points (2 weeks, 3 months and 6 months) (p<0.001). These improvements were sustained through the 6-month follow-up. However, there was no statistically significant difference in the extent of improvement between the two treatment groups (p>0.05). Conclusions: SSSB and the combination of SAI + IAI demonstrated comparable clinical efficacy in the management of chronic shoulder pain unresponsive to conservative treatment. However, SSSB, being less invasive, offers advantages in terms of ease of administration and patient comfort. Moreover, its therapeutic effects were sustained for up to six months. These findings suggest that SSSB may be considered an effective standalone interventional treatment option in this patient population.

Anahtar Kelimeler

• Shoulder pain
• Suprascapular nerve block
• Subacromial injection
• Intra-articular injection
• SPADI

Kaynakça

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