Lomber Faset Sendromlu Hastalarda Pulse Radyofrekans Uygulamasının Sağlıkla İlişkili Yaşam Kalite Üzerinde Etkileri

Yıl 2023, Cilt: 10 Sayı: 1, 1 - 5, 10.04.2023

Kemal Paksoy

https://doi.org/10.47572/muskutd.1002687

Öz

Pulse radyofrekans (PRF) tedavisi lomber faset sendromuna (LFS) bağlı ağrı tedavisi için analjezi sağlamada alternatif tedavi olarak önerilmektedir. Bu çalışmada klinik başarının yanında sağlıkla ilgili yaşam kalitesi üzerine etkinliğinin değerlendirilmesi amaçlanmıştır. LFS nedeni ile PRF uygulaması yapılan hastalarda klinik etkinliği değerlendirmek için Vizüel Ağrı Skalası (VAS) ve Oswestry Özürlülük İndeksi (OÖİ) kullanıldı. Sağlıkla ilgili yaşam kalite değerlendirmesi ise Medical Outcome Study Short Form-36 (SF-36) ile yapıldı. Değerlendirme işlem öncesi, işlem sonrası birinci ay ve on ikinci ayda yapıldı. Toplam 12 hastaya PRF uygulaması yapıldı. İşlem öncesi ile işlem sonrası birinci ay ve on ikinci ay VAS ve OÖİ değerlerindeki değişiklikler istatistiksel olarak anlamlıydı (p<0.001). Aynı şekilde SF-36 değerlendirmesindeki değişiklikler de işlem öncesine göre işlem sonrası birinci ay ve on ikinci ayda anlamlıydı (p<0.001). LFS hastalarında PRF uygulaması ağrı üzerinde iyileştirici etkiye sahiptir. Lomber faset sendromuna bağlı oluşan bel ağrılarının hastalarda sağlıkla ilgili yaşam kalitelerini bozduğu tedavi sonrasında ise tatmin edici yaşam kalitesine kavuşmaya yardım ettiği tespit edildi. Bu tarz ağrılarda PRF uygulamasının etkinliği akılda tutulmalıdır.

Anahtar Kelimeler

Kısa Form-36, Lomber Faset Sendromu, Oswestry Özürlülük İndeksi, Pulse Radyofrekans, Vizüel Ağrı Skalası

Effects of Pulse Radiofrequency Application on Health-Related Quality of Life in Patients with Lumbar Facet Syndrome

Öz

Pulse radiofrequency (PRF) therapy is recommended as an alternative therapy to provide analgesia for the treatment of pain associated with lumbar facet syndrome (LFS). In this study, it was aimed to evaluate its effectiveness on the health-related quality of life as well as clinical success. Visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate clinical efficacy in patients who underwent PRF for LFS. Health-related quality of life assessment was done with the Medical Outcome Study Short Form-36 (SF-36). Evaluation was done before the procedure, at the first month and at the twelfth month after the procedure. A total of 12 patients underwent PRF. The changes in VAS and ODI values before the procedure and at the first and 12th months after the procedure were statistically significant (p<0.001). Likewise, the changes in the SF-36 evaluation were significant in the first and twelfth months after the procedure compared to the pre-procedure (p<0.001). PRF application has a healing effect on pain in LFS patients. It has been determined that low back pain due to lumbar facet syndrome impairs the health-related quality of life of the patients and helps to achieve a satisfactory quality of life after the treatment. The effectiveness of PRF application should be kept in mind in such pains.

Anahtar Kelimeler

Short Form-36, Lumbar Facet Syndrome, Oswestry Disability İndex, Pulse Radiofrequency, Visual Analog Scale

Kaynakça

• 1. Berthonnaud E, Dimnet J, Roussouly P, et al. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech. 2005;18(1):40-7.
• 2. Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology. 2007;106(3):591-614.
• 3. Filippiadis DK, Kelekis A. A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies. Br J Radiol. 2016;89:20150357.
• 4. Hancock MJ, Maher CG, Latimer J, et al. Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain. EurSpine J. 2007;16(10):1539–50.
• 5. Falco FJ, Manchikanti L, Datta S, et al. An update of the systematic assessment of the diagnostic accuracy of lumbar facet joint nerve blocks. Pain Physician. 2012;15(6):869–907.
• 6. Manchikanti L, Singh V, Falco FJ, et al. Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain: a randomized, double-blind, controlled trial with a 2-year follow-up. Int J MedSci. 2010;7:124–35.
• 7. Wu T, Zhao WH, Dong Y, et al. Effectiveness of ultrasound-guided versus fluoroscopy or computed tomography scanning guidance in lumbar facet joint injections in adults with facet joint syndrome: a meta-analysis of controlled trials. Arch Phys Med Rehabil. 2016;97:1558–63.
• 8. Cahana A. Pulsed radiofrequency: a neurobiologic and clinical reality. Anesthesiology. 2005;103(6):1311.
• 9. Weishaupt D, Zanetti M, Boos N, et al. MR imaging and CT in osteoarthritis of the lumbar facet joints. Skeletal Radiol. 1999;28:215-9. 10. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (sf-36). I. Conceptual framework and item selection. Med Care. 1992;30:473-83.
• 11. Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13:227-36.
• 12. Fritz JM, Irrgang JJ. A comparison of a modified Oswestry low back pain disability questionnaire and the Quebec back pain disability scale. Phys Ther. 2001;81:776-88.
• 13. Urits I, Burshtein A, Sharma M, et al. Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment. Curr Pain Headache Rep. 2019;23(3):23.
• 14. Langley P, Müller-Schwefe G, Nicolaou A, et al. The societal impact of pain in the European Union: health-related quality of life and healthcare resource utilization. J Med Econ. 2010;13:571–81.
• 15. Faber F. Lumbar facet joint disease: Classification, clinical diagnostics, and minimally invasive treatment. Orthopade. 2019;48:77-83.
• 16. Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology. 2007;106:591–614.
• 17. Proietti L, Schirò GR, Sessa S, et al. The impact of sagittal balance on low back pain in patients treated with zygoapophysial facet joint injection. Eur Spine J. 2014;23:628-33.
• 18. Sansone P, Giaccari LG, Lippiello A, et al. Pulsed radiofrequency for lumbar facet joint pain: a viable therapeutic option? A retrospective observational study. Pain Ther. 2020;9(2):573-82.
• 19. Moussa WM, Khedr W, Elsawy M. Percutaneous pulsed radiofrequency treatment of dorsal root ganglion for treatment of lumbar facet syndrome. Clin Neurol Neurosurg. 2020;199:106253.
• 20. Tekin I, Mirzai H, Ok G, et al. A comparison of conventional and pulsed radio frequency denervation in the treatment of chronic facet joint pain. Clin J Pain. 2007;23(6):524–9.
• 21. Kroll HR, Kim D, Danic MJ, et al. A randomized, double-blind, prospective study comparing the efficacy of continuous versus pulsed radiofrequency in the treatment of lumbar facet syndrome. J Clin Anesth. 2008;20(7):534–7.
• 22. Chang MC, Cho YW, Ahn DH, et al. Intraarticular pulsed radiofrequency to treat refractory lumbar facet joint pain in patients with low back pain. World Neurosurg. 2018;112:140-4.