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Volume: 35  Issue: 1   Year: 2023
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  An unusual obstacle to the thoracic interlaminar epidural injection for the treatment of post-herpetic neuralgia [Ağrı]
Ağrı. 2023; 35(1): 44-47 | DOI: 10.14744/agri.2020.68878  

An unusual obstacle to the thoracic interlaminar epidural injection for the treatment of post-herpetic neuralgia

Serhad Bilim, Savaş Şencan, Osman Hakan Gündüz
Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, İstanbul, Türkiye

Interlaminar epidural steroid injections corresponding to dermatomes affected by post-herpetic neuralgia (PHN) were found effective in reducing pain. Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory condition that mainly occurs with calcification and ossification of spinal ligaments such as anterior and posterior longitudinal, interspinous, supraspinous ligament, and ligamentum flavum. In this case, it is presented that the failure of the access to the T7-T8 interlaminar space due to the supra/interspinous ligament calcification and ossification accompanied by thoracic DISH in a 73-year-old male for the treatment of PHN.

Keywords: Diffuse idiopathic skeletal hyperostosis, epidural injection, pathologic calcification, postherpetic neuralgia, thoracic spondylosis, thoracic vertebrae.


Postherpetik nevralji tedavisinde torasik interlaminar epidural enjeksiyonuna beklenmedik bir engel

Serhad Bilim, Savaş Şencan, Osman Hakan Gündüz
Ağrı Tıp Anabilim Dalı, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Marmara Üniversitesi Tıp Fakültesi, İstanbul, Türkiye

Postherpetik nevraljide etkilenen dermatomlara yönelik interlaminar epidural steroid enjeksiyonlarının ağrıyı azaltmada etkili olduğu bulundu. Diffüz idiyopatik iskelet hiperostozu esas olarak anterior ve posterior longitudinal ligament, interspinöz, supraspinöz ligament ve ligamentum flavum gibi spinal ligamentlerin kalsifikasyonu ve kemikleşmesi ile ortaya çıkan inflamatuvar olmayan bir durumdur. Bu olguda, 73 yaşında postherpetik nevraljisi olan bir erkek hastada, torakal diffüz idiyopatik iskelet hiperostoza eşlik eden supra/interspinöz ligament kalsifikasyonu ve kemikleşme nedeniyle T7-T8 interlaminar epidural alana erişimin başarısız olma durumu sunuldu.

Anahtar Kelimeler: Epidural Enjeksiyon, diffüz idiopatik iskelet hiperostozu, patolojik kalsifikasyon, postherpetik nevralji, torakal spondiloz, torakal vertebra.


Serhad Bilim, Savaş Şencan, Osman Hakan Gündüz. An unusual obstacle to the thoracic interlaminar epidural injection for the treatment of post-herpetic neuralgia. Ağrı. 2023; 35(1): 44-47

Corresponding Author: Serhad Bilim, Türkiye


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