[Efficacy of transforaminal lumbar epidural steroid injections in patients with lumbar radiculopathy]. / Lumbar radikülopatili hastalarda transforaminal lumbar epidural steroid enjeksiyonlarinin etkinligi.

OBJECTIVES: This study looks into the efficacy and safety of the transforaminal lumbar epidural steroid injection (TLESI) applied to patients with radiculopathy due to lumbar disk herniation. METHODS: The patients' files which were applied TLESI, were retrospectively scanned. Patients who did not respond to one-month conservative treatment and who were detected to have bulging or protruding lumbar disk herniation as a result of imaging methods were included in the study. All applications were performed with C-arm fluoroscopy under local anesthesia by outpatient method. In all cases, a mix of 80 mg triamsinolone and 0.25% bupivacaine, was transforaminally injected to the anterior epidural area. Initial VAS pain scores were compared with the values of the 1, 3 and 6th months after the application. Patient satisfaction was determined through scoring. Furthermore, early and late term complications were collected for evaluation. RESULTS: A total of 222 patients were administered TLESI 460 times (average: 2.1, repeat interval: 1-6 times). The applications were carried out most frequently at the levels of L4-L5 and L5-S1. While the initial VAS score average was 8.2±0.7, after TLESI, it was 5.0±1.6, 4.8±1.5 and 5.1±1.5 in the 1, 3 and 6th months, respectively. 63.9% of the patients (n=142) defined the treatment as 'good and excellent'. No major complications were experienced and the overall minor complication rate was 11.1%. CONCLUSION: It was seen that TLESI was an efficient and safe method in the short and medium term.

[Our percutaneous vertebroplasty applications in vertebral compression fractures]. / Vertebra kompresyon kiriklarinda perkütan vertebroplasti uygulamalarimiz.

OBJECTIVES: We aimed to investigate the effectiveness and complications of the percutaneous vertebroplasty (PVP) applications in vertebral compression fractures. METHODS: Our study was carried out as a retrospective study in which PVP was conducted on patients with vertebral compression fractures due to benign or malignant causes between October 2006 and December 2009. The patients' pain was evaluated on a visual analog scale (VAS). In addition, the amount of cement injected, whether or not any leakage from the vertebrae corpus was seen, and any complications resulting from the application during or after the operation were recorded. The age and gender of the patients, duration of pain, number and location of fractured vertebrae, and the duration of follow-up were also collected for evaluation. RESULTS: A total of 15 patients were included in the assessment. Of the patients, 13 were female, and the mean age was 69.5±8.5 years. A total of 19 PVPs were applied to the 15 patients. While initial VAS scores were 7.9±1.6, at the end of an average of 10.3±3.8 (range: 4-18) months of follow-up, VAS scores had fallen to 2.6±2.7. 80% of the patients reported at least a 50% reduction in pain scores compared to initial scores, and 86.7% of them reported at least a 2-point decrease in VAS scores. In three patients, leakage of cement into the intervertebral disc occurred. CONCLUSION: PVP may be used successfully in symptomatic vertebral compression fractures not responding to medical treatment, with a low rate of complications.