The diagnosis of herniated disks with the use of lumbar epidural phlebography is discussed. Fifty patients were examined. The diagnosis was verified during the operation in 38 of 44 patients. Proper technical performance of the procedure provides the possibility for localizing the herniated disk with high precision, which is very important in surgical management. The relatively simple techniques, the absence of serious complications, and the exactness of the diagnosis provide the grounds for recommending transfemoral lumbar epidural phlebography for wide use.
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Anesth Pain Med (Seoul)
November 2024
Department of Anesthesia and Pain Medicine, Alfayoum University, Alfayoum, Egypt.
Background: Failed back surgery syndrome is a common problem faced by chronic pain management specialists. Steroid-only epidural injections have modest efficacy because of excessive scarring. Epidural hyaluronidase (HA), functions as a depolymerizing agent, successfully breaking down adhesions and collagen bundles, whereas dexmedetomidine (DEX) helps to reduce inflammation.
View Article and Find Full Text PDFAnesth Pain Med (Seoul)
January 2025
Department of Anesthesia, Intensive Care and Pain Medicine, Faculty of Medicine, Alfayoum University, Alfayoum, Egypt.
Background: Epidural steroid injections are frequently used to treat chronic radicular pain of a discogenic origin; however, their efficacy remains limited. Magnesium sulfate and dexmedetomidine are emerging adjuvants with the potential to enhance the effectiveness and prolong the therapeutic duration of steroid injections.
Methods: In this randomized, double-blind study, 90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse who did not respond to conservative treatment for 12 weeks were assigned to three groups.
Eur Spine J
January 2025
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Purpose: Spinal epidural abscesses are rare yet serious conditions, often necessitating emergency surgical intervention. Holospinal epidural abscesses (HEA) extending from the cervical to the lumbosacral spine are even rarer and present significant challenges in management. This report aims to describe a case of HEA with both ventrally-located cervical and dorsally-located thoracolumbar epidural abscesses treated with a combination of anterior keyhole decompression and posterior skip decompression surgeries.
View Article and Find Full Text PDFNeurosciences (Riyadh)
January 2025
From the Department of Algology (Göksu), Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, from the Department of Algology (Celik, Akcaboy, Şahin), University of Health Sciences Ankara City Hospital, Ankara, from Ankara Gaziler PMR Training and Research Hospital (Baran), University of Health Sciences, Ağrı, from the Department of Algology (Yıldız), University of Health Sciences Ankara Etlik City Hospital, Ankara, from the Department of Algology (Kaya), Adıyaman University Training and Research Hospital, Adıyaman, and from the Department of Algology (Ayhan), Dumlupinar University Kutahya Evliya Celebi Training and Research Hospital, Kütahya, Turkey.
Objectives: To compare the effectiveness of preganglionic transforaminal epidural steroid injection (TFESI) with preganglionic plus postganglionic TFESI.
Methods: Patients with unilateral radicular pain and disc pathology were randomly assigned to either the preganglionic group or the preganglionic plus postganglionic group. All patients were evaluated using a numeric rating scale (NRS) and a patient satisfaction scale (PSS) at the third week and the third month after treatment.
J Clin Med
December 2024
Department of Anesthesiology and Reanimation, School of Medicine, Ankara University, 06100 Ankara, Turkey.
To compare the efficiency of unilateral and bilateral transforaminal epidural steroid injections (TFESI) in patients with unilateral lumbar disc herniation (LDH). In this prospective randomized single-blinded study, patients with unilateral LDH were randomly divided into two groups: A unilateral TFESI group; and a bilateral TFESI group. The severity of pain and disability were assessed with the Numeric Rating Scale (NRS-11) and Oswestry Disability Index (ODI) at baseline, 1 week, 1 month, and 3 months after interventions.
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