AIm:The study was conducted to compare the clinical effectiveness of FJ injections (FJI) and FJ radiofrequency (FJRF) denervation in patients with chronic low back pain. mAterIAl and methOds:This study included 100 patients; 50 in FJI 50 in FJRF group. VNS, NASS and EQ-5D were used to evaluate the outcomes. All outcome assessments were performed at baseline, 3 months, 6 months and 12 months. results: FJI in early post-op but FJRF in 1st, 6th and 12th month VNS showed better results (p<0.001). There was no significant difference in the 1st (p=1) and 6th month (p=0.13) but in 12th month (p=0.04) in NASS. Increase in level number showed positive effect in NASS in FJRF group (p=0.018) but no effect in FJI group (p=0.823) in the 12th month follow-up. There was no significant difference with respect to 1st month (p=0.17), 6th month (p=0.22) and 12th month (p=0.11) post-procedure follow-ups in EQ-5D. At the short term FJI was more effective than FJRF however in midterm follow-up FJRF had more satisfying results than FJRF.COnClusIOn: To our knowledge, the first choice should be the FJI and if pain reoccurs after a period of time or injection is not effective, RF procedure should be used for the treatment of chronic lumbar pain.KeywOrds: Facet, Joint, Injection, Radiofrequency, Denervation, Low back pain ÖZ AmAÇ: Lomber faset eklem (FE) bozuklukları kronik bel ağrılarının en sık sebebidir. Bu çalışmada, kronik bel ağrılı hastalarda uygulanan FE enjeksiyonu (FEE) ve radyofrekans denervasyonunun (FER) klinik sonuçlarının karşılaştırılması amaçlamaktadır. yÖntem ve GereÇler: Bu çalışmaya 50 FEE ve 50 FER yapılan 100 hasta dahil edildi. VNS, NASS ve EQ-5D sonuçların değerlendirilmesi amacıyla kullanıldı. Sonuçlar başlangıç, 3. ay, 6. ay ve 12. aylarda elde edildi.BulGulAr: FEE işlem sonrası erken dönemde, FER ise 1., 6. ve 12. ayda daha etkiliydi (p<0,001). NASS sonuçlarında 1. (p=1) ve 6. ayda (p=0.13) anlamlı fark yokken 12. ayda (p=0,04) vardı. İşlem yapılan segment sayısı FER grubunun (p=0,018) 12. aydaki NASS sonucunu pozitif yönde etkilerken FEE grubunda (p=0,823) etkisi yoktu. EQ-5D sonuçları açısından 1. (p=0,17), 6. (p=0,22) ve 12. ayda (p=0,11) iki grup arasında anlamlı fark saptanmadı. Kısa dönemde FEE daha etkiliyken orta dönemde FER'in sonuçları daha başarılıydı. sOnuÇ: Faset eklemden kaynaklanan bel ağrılarında, FEE ve FER birer tedavi seçenekleridir. Sonuçlarımıza göre, kronik bel ağrısının tedavisinde FEE ilk seçenek olarak düşünülmeli ve bir süre sonra tekrarlayan veya FEE etkili olmadığı durumlarda FER tedavi amacıyla kullanılmalıdır.
Carpal tunnel syndrome (CTS) is a common focal peripheral neuropathy. Increased pressure in the carpal tunnel results in median nerve compression and impaired nerve perfusion, leading to discomfort and paresthesia in the affected hand. Surgical division of the transverse carpal ligament is preferred in severe cases of CTS and should be considered when conservative measures fail. A through knowledge of the normal and variant anatomy of the median nerve in the wrist is fundamental in avoiding complications during carpal tunnel release. This paper aims to briefly review the anatomic variations of the median nerve in the carpal tunnel and its implications in carpal tunnel surgery. KeywOrds: Median nerve, Anatomic variation, Carpal tunnel, Transverse carpal ligament ÖZKarpal tünel sendromu (KTS) sık görülen bir periferik nöropatidir. Karpal tünel basıncının artması median sinirin sıkışmasına ve kanlanmasının bozulmasına yol açar. Ağır vakalarda ve konservatif tedavinin yeterli olmadığı durumlarda cerrahi olarak transvers karpal ligamanın kesilmesi tercih edilir. Karpal tünelin gevşetilmesi sırasında komplikasyonlardan kaçınmak için median sinirin bu bölgedeki ayrıntılı anatomisinin ve varyasyonlarının iyi bilinmesi gereklidir. Bu derleme median sinirin karpal tüneldeki olası anatomik varyasyonlarını ve bunun karpal tünel cerrahisine etkilerini kısaca gözden geçirmek amacıyla yazılmıştır.
If the patients experience severe or mild back pain with higher preoperative KA, especially in the first 2 months, then they deserve detailed radiologic examination. To avoid subsequent fracture in the same or adjacent level, vertebral body should be filled adequately and sagittal balance should be obtained with KA correction. BK alone did not influence the incidence of subsequent VCF.
Our data suggest that RFT destruction of ganglion impar in patients with chronic coccydynia has an effective outcome and patients responding to RFT have significantly lower post-RFT pain scores. The most important factors determining success of this procedure is strict patient selection criteria and the technique of the procedure.
Remote cerebellar haemorrhage (RCH) is a rare but potentially lethal complication of spinal surgery resulting from inadvertent opening of the dura. The precise mechanism of this type of haemorrhage remains undetermined. Magnetic resonance imaging (MRI) may show a ‘Zebra sign’ representing the horizontal curvilinear configuration of haemorrhage between the cerebellar folia.
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