LOMBER DİSK HERNİASYONLU HASTALARDA DRG-PULSED RADYOFREKANS, STEROİD VE KOMBİNE TEDAVİLERİN OSWESTRY ÖZÜRLÜLÜK İNDEKSİ ÜZERİNE ETKİLERİNİN KARŞILAŞTIRILMASI

Öz

AMAÇ: Bu çalışmada, cerrahi dışı tedavi uygulanan ekstrüde veya sekestre lomber disk hernisi bulunan hastalarda, dorsal kök ganglionuna (DRG) uygulanan darbeli radyofrekans (PRF), steroid enjeksiyonu ve her ikisinin kombinasyonunun klinik etkinliğini karşılaştırmak ve Oswestry Yetersizlik İndeksi (ODI) skorları üzerindeki fonksiyonel sonuçlarını değerlendirmek amaçlandı.
GEREÇ VE YÖNTEM: 2020–2024 yılları arasında cerrahiye aday olmayan ve konservatif tedaviye yönlendirilen toplam 90 lomber disk hernili hasta çalışmaya dahil edildi. Hastalar aldıkları tedaviye göre üç gruba ayrıldı: yalnızca DRG-PRF (Grup 1), yalnızca steroid + lokal anestezik enjeksiyonu (Grup 2) ve PRF sonrası steroid enjeksiyonu ile kombine tedavi (Grup 3). ODI skorları tedavi öncesinde, 1. ayda ve 6. ayda kaydedildi. Veriler SPSS yazılımı ile analiz edildi, p<0.05 anlamlı kabul edildi.
BULGULAR: Başlangıçta ODI skorları tüm gruplar arasında benzerdi (p=0.417). Birinci ayda tüm gruplarda anlamlı iyileşme gözlendi (p<0.001). Altıncı ayda ise steroid grubunda etkinin azaldığı görüldü (p=0.063), PRF ve özellikle PRF+steroid gruplarında ise anlamlı iyileşmenin devam ettiği saptandı (sırasıyla p=0.002 ve p=0.004). Her iki takip döneminde de en düşük ODI skorları kombine tedavi grubunda izlendi (p<0.001). Alt grup analizinde, iki seviyeli hernisi olan hastaların tek seviyeli hernisi olanlara kıyasla daha az iyileştiği görüldü (p=0.041).
SONUÇ: DRG-PRF, steroid ve kombine uygulamalar, lomber disk hernili hastalarda kısa dönem semptomatik iyileşme sağlar. Ancak kombine tedavi, orta dönemde etkinliğini sürdürerek en düşük ODI skorlarını sunmuştur. Bu bulgular, cerrahi dışı tedavi düşünülen hastalarda kombine yaklaşımın öncelikli olarak değerlendirilmesi gerektiğini düşündürmektedir.

Anahtar Kelimeler

• Lomber disk hernisi
• Radyo­frekans
• Dorsal kök ganglionu
• Steroid enjeksiyonu
• Oswestry Özürlülük İndeksi

COMPARATIVE EFFECTS OF DRG-PULSED RADIOFREQUENCY, STEROID, AND COMBINED THERAPIES ON OSWESTRY DISABILITY INDEX IN PATIENTS WITH LUMBAR DISC HERNIATION

Öz

OBJECTIVE: This study aimed to compare the clinical efficacy of pulsed radiofrequency (PRF) applied to the dorsal root ganglion (DRG), steroid injection, and their combination in patients with extruded or sequestered lumbar disc herniation who underwent non-surgical treatment, and to evaluate their effects on functional outcomes using the Oswestry Disability Index (ODI) scores.
MATERIAL AND METHODS: Between 2020 and 2024, a total of 90 patients with lumbar disc herniation who were not considered candidates for surgery and were referred for conservative treatment were included in the study. Patients were divided into three groups according to the treatment received: DRG-PRF only (Group 1), steroid + local anesthetic injection only (Group 2), and combined treatment with PRF followed by steroid injection (Group 3). ODI scores were recorded before treatment, at the 1st and 6th months. Data were analyzed using SPSS software, with p<0.05 considered statistically significant.
RESULTS: At baseline, ODI scores were similar across all groups (p=0.417). At the 1st month, significant improvement was observed in all groups (p<0.001). At the 6th month, efficacy decreased in the steroid group (p=0.063), whereas significant improvement was maintained in the PRF and particularly in the PRF+steroid groups (p=0.002 and p=0.004, respectively). The combined therapy group had the lowest ODI scores at both follow-up periods (p<0.001). Subgroup analysis revealed that patients with two-level herniation improved less than those with single-level herniation (p=0.041).
CONCLUSIONS: DRG-PRF, steroid, and combined applications provide short-term symptomatic improvement in patients with lumbar disc herniation. However, combined therapy maintained its efficacy mid-term, offering the lowest ODI scores. These findings suggest that the combined approach should be prioritized in patients considered for non-surgical treatment.

Anahtar Kelimeler

• Lumbar disc herniation
• Pulsed radiofrequency
• Dorsal root ganglion
• Steroid injection
• Oswestry Disability Index.

Kaynakça

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