ISSN : 1300-0012   E-ISSN 2458-9446 Home      |      Contact      |      TR
 
 
Volume: 32  Issue: 4  Year: 2020
 

Attention: These articles have been accepted for publication; however, this list does not indicate the order in which articles will be published. As new articles are accepted, the order displayed here will change.

The Long-Term Effects of Plasma Disc Coagulation Therapy for Cervical Disc Hernia [Ağrı]
Ağrı. Ahead of Print: AGRI-28482 | DOI: 10.14744/agri.2020.28482  

The Long-Term Effects of Plasma Disc Coagulation Therapy for Cervical Disc Hernia

Sibel Özcan1, Arzu Muz2, Serhat Taskin1, Ahmet Kürşat Poyraz3, Selami Ates Onal4
1Department of Anaesthesiology and Reanimation, Faculty of Medicine, Firat University, Elazig, Turkey
2Section of Pain Management, Ankara Training and Research Hospital, Ankara, Turkey
3Department of Radiology, Faculty of Medicine, Firat University, Elazig, Turkey
4Section of Pain Management, Acibadem Hospital, İstanbul, Turkey

Objectives: Recently, plasma disc coagulation therapy (PDCT) has been used in the treatment of lumbar and cervical disc hernia (CDH), but the long-term effects of PDCT have not been well documented. The aim of this study was to assess the long-term effects of PDCT on pain score, disc volume and patient satisfaction in patients with CDH.
Methods: Eighty patients with CDH, who underwent PDCT treatment, were included in the study. The patients demographics and pain scores (visual analog scale-VAS) were recorded on the baseline and in the 1st, 3rd, 6th and 12th month after PDCT treatment. We evaluated patient satisfaction and disc volume on the 12th month after PDCT.
Results: A statistically significant and time-dependent decrease was determined in VAS score. The initial mean VAS score was 6.5 ± 0.9, and it decreased to 3.4 ± 0.2 on the final follow-up (p<0.01). According to magnetic resonance imaging pathology, VAS score after PDCT was higher in patients with an extruded disc when compared to patients with bulging and protruded discs at all times (p<0.05). After 12 months, 50 % of the patients were reported as excellent and 8.7 % of the patients reported as poor based on the Odoms’ criteria. Disc volume decreased after PDCT treatment in the patients who reported that they were excellent based on the Odoms’ criteria (p<0.01).
Conclusions: This study demonstrated that PDCT is a safe, effective and minimally invasive treatment technique for adequately selected patients with CDH.

Keywords: Cervical disc hernia, plasma laser therapy, disc volume, visual analog scale.


Servikal Disk Hernisinde Plazma Disk Koagülasyon Tedavisinin Uzun Dönem Etkileri

Sibel Özcan1, Arzu Muz2, Serhat Taskin1, Ahmet Kürşat Poyraz3, Selami Ates Onal4
1Fırat Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon ABD, Elazığ, Türkiye
2Ankara Eğitim ve Araştırma Hastanesi, Algoloji Kliniği, Ankara, Türkiye
3Fırat Üniversitesi Tıp Fakültesi, Radyoloji ABD, Elazığ, Türkiye
4Acıbadem Hastanesi, Algoloji Kliniği, İstanbul, Türkiye

Amaç: Son zamanlarda, lomber ve servikal disk hernisi (SDH) tedavisinde plazma disk koagülasyon tedavisi (PDCT) kullanılmıştır, ancak PDCT' nin uzun dönem etkileri tam olarak belgelenmemiştir. Bu çalışmanın amacı, servikal disk hernili hastalarda PDCT' nin ağrı skoru, disk hacmi ve hasta memnuniyeti üzerindeki uzun dönem etkilerini değerlendirmektir.
Gereç ve Yöntem: PDCT tedavisi uygulanan 80 SDH hastası çalışmaya alındı. Hastaların demografik özellikleri ve ağrı skorları (görsel analog skala-VAS) başlangıçta ve PDCT tedavisinden sonraki 1., 3., 6. ve 12. aylarda kaydedildi. PDCT'den sonraki 12. ayda hasta memnuniyeti ve disk hacmi değerlendirildi.
Bulgular: VAS skorunda zaman bağımlı ve istatistiksel olarak anlamlı azalma saptandı. Başlangıçtaki VAS skoru 6.5 ± 0.9 iken, son takipte 3.4 ± 0.2 olarak tespit edildi (p <0.01). Manyetik rezonans görüntüleme patolojisine göre, PDCT sonrası VAS skoru ekstrüde diski olan hastalarda, bulging ve protrüzyon olan hastalara göre daha yüksekti (p <0.05). Tedaviden 12 ay sonra Odom kriterlerine göre hastaların % 50'si mükemmel olduğunu bildirirken, % 8,7’si kötü olduğunu rapor etti. PDCT tedavisinden sonra Odom kriterlerine göre mükemmel olduğunu bildiren hastalarda disk hacminin azaldığı tespit edildi. (p <0.01).
Sonuç: Bu çalışma PDCT'nin seçilmiş SDH’li hastalar için güvenli, etkili ve minimal invaziv bir tedavi tekniği olduğunu göstermiştir.

Anahtar Kelimeler: Servikal disk hernisi, plazma lazer tedavi, disk hacmi, vizüel analog skala




Corresponding Author: Sibel Özcan, Türkiye


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