Amaç: Dünyada yaygýn olarak kullanýlan analjezik ve antipiretiklerin baþýnda gelen parasetamol, gebelik döneminde en sýk kullanýlan analjezik ve antipiretik ajandýr. Parasetamolün karaciðer, akciðer ve böbrek üzerine toksik etkisi olduðu bilinmektedir. Çalýþmamýzda gebeliðin farklý trimesterlerinde uzun dönem kronik parasetamol maruziyetinin yeni doðan ratlarda akciðer, karaciðer ve böbrek üzerine etkilerini araþtýrdýk.
Gereç ve Yöntem: Çalýþmamýzda kontrol (grup C), birinci trimester (grup A), üçüncü trimester (grup B) gruplarý oluþturuldu. Grup A’ya gebeliðin ilk yedi günü, grup B’ye ise 15–21. günleri arasýnda parasetamol oral yoldan verildi. Doðum sonrasý üçüncü günde yeni doðan ratlara 50 mg/kg ketamin intraperitoneal uygulanarak sakrifiye edildi ve sonrasýnda akciðer, karaciðer ve böbrek dokularý inceleme için uygun koþullarda alýnarak saklandý. Toplam 70 yavru dokularýnda histopatolojik ve biyokimyasal inceleme yapýldý.
Bulgular: Iþýk mikroskopisi incelemesinde akciðer dokusu konjesyon (p<0.0001), eritrosit varlýðý (p<0.0001) açýsýndan, karaciðer dokusunda ise inflamasyon (p<0.0001), vakuoler dejenerasyon (p<0.0001) ve sinüzoidal dilatasyon A ve B gruplarýnda kontrol grubuna göre anlamlý farklýlýk bulundu. Böbrek doku incelemesinde anlamlý fark saptanmadý (p>0.05). MDA ve serbest radikal metabolizmasýnda etkin olan enzimlerden CAT, GPx, SOD aktiviteleri deðerlendirildi. Akciðer ve böbrek dokularýnda gruplar arasýnda anlamlý farklar saptanmazken, karaciðer dokusunda oksidan parametreler anlamlý olarak farklý bulundu.
Sonuç: Farklý trimesterlerde subakut dozda kronik kullanýlan parasetamolün yenidoðan ratlarýn akciðer, karaciðer ve böbrek dokularýnda hasara neden olduðunu tespit ettik.

Objectives: Paracetamol is one of the most widely used analgesics and antipyretics in the world. It is the most commonly used analgesic and antipyretic agent in pregnancy. Paracetamol is known to have toxic effects on the liver, lung, and kidney. In this study, we investigated the effects of long-term chronic paracetamol exposure on the lung, liver, and kidney in newborn rats at different trimesters of pregnancy.
Methods: In our study, we formed control (group C), first trimester (group A), and third trimester (group B) groups. Group A had the first seven days of pregnancy and group B had days 15–21. Paracetamol was given orally during the specified periods. On the third postnatal day, pups were euthanized by applying 50 mg/kg ketamine intraperitoneally, and then lung, liver, and kidney tissues were kept under appropriate conditions for examination. A total of 70 pups underwent histopathological examination.
Results: The lung revealed congestion (p<0.0001), and erythrocytes (p<0.0001), the liver revealed significant histopathological findings in terms of the presence of inflammation (p<0.0001), vacuolar degeneration (p<0.0001), and sinusoidal dilatation in groups A and B compared to the control group under light microscopy. MDA and free radical metabolism enzyme activities, CAT, GSH, and SOD were evaluated. While there were no significant differences between the groups in lung and kidney tissues, oxidant parameters were significant in liver tissues.
Conclusion: Our data point out that subacute doses of paracetamol used chronically in different trimesters caused damage to the lung, liver, and kidney tissues of pups.

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Amaç: Bu çalýþmada, meme cerrahisinde etkinliði kanýtlanmýþ erektör spina düzlem bloðunun farklý volümlerde, ayný konsantrasyonda lokal anestezik ile uygulanmasý durumunda intraoperatif opioid tüketimi ve postoperatif analjezi üzerindeki etkinliði araþtýrýldý.
Gereç ve Yöntem: Çalýþma, randomize, prospektif ve çift-kör olarak dizayn edildi. Çalýþmaya, 18–70 yaþ arasý ASA I-III, elektif meme cerrahisi geçirecek 70 hasta dahil edildi. Grup I’deki 35 hastaya %0.375’lik bupivakain hidroklorür 20 ml ile, Grup II’deki 35 hastaya %0.375’lik bupivakain hidroklorür 30 ml ile unilateral erektör spina düzlem bloðu yapýldý. Ameliyat süresince cerrahi pletismografik indeks ile hastalarýn analjezik ihtiyacý monitörize edildi. Hastalarýn intraoperatif ve postoperatif ilk 24 saat opioid tüketimleri ve kurtarýcý analjezik ihtiyaçlarý ile postoperatif 10. dakika, 1. saat, 6. saat, 12. saat ve 24. saatteki NRS skorlarý kaydedildi.
Bulgular: Hem intraoperatif hem de postoperatif opioid tüketimi gruplar arasýnda benzerdi (p>0.05). Tutulan dermatom sayýlarý Grup II’de anlamlý derecede yüksekti (p<0.05). Postoperatif NRS skorlarý arasýnda istatistiksel fark saptanmadý (p>0.05).
Sonuç: Elektif meme cerrahisinde, ayný konsantrasyonda 20 veya 30 ml volümlerde uygulanan erektör spina düzlem bloðu, opioid tüketimi ve postoperatif analjezi üzerinde fark oluþturmamaktadýr.

Objectives: We investigated the efficacy of the erector spinae plane block, which has been proven to be effective in breast surgery, on intraoperative opioid consumption and postoperative analgesia when administered in different volumes with the same concentration of local anesthetic.
Methods: This study is designed as randomized, prospective, and double-blind. Seventy patients aged between 18–70 years, undergoing ASA I-III elective breast surgery, were included. Unilateral erector spinae plane block was achieved by administering 20 mL of 0.375% bupivacaine hydrochloride in 35 patients in Group I and 30 mL of 0.375% bupivacaine hydrochloride in 35 patients in Group II. The analgesic requirement of the patients was monitored with the surgical plethysmographic index throughout the surgery. Intraoperative and postoperative opioid consumption, rescue analgesic requirements in the first 24 hours, and NRS scores at the 10th minute, 1st hour, 6th hour, 12th hour, and 24th hour postoperatively were recorded.
Results: Both intraoperative and postoperative opioid consumptions were similar between groups (p>0.05). The number of involved dermatomes was significantly higher in Group II (p<0.05). No significant difference was found between postoperative NRS scores (p>0.05).
Conclusion: In elective breast surgery, erector spinae plane block administered at the same concentration in 20 or 30 mL volumes does not make a difference in opioid consumption and postoperative analgesia.

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Amaç: Pterigopalatin fossada yer alan Sphenopalatine Ganglion (SPG) otonomik sinir sistemindeki rolü gereði baþ aðrýlarý baþta olmak üzere kas iskelet sistemi aðrýlarýnda da giriþimsel iþlemlerin hedefi olmaktadýr. Çalýþmamýz, fibromiyalji hastalarýnda transnazal sphenopalatine ganglion blokajýnýn (SPGB) aðrý, fonksiyonel kapasite, uyku ve depresyon üzerindeki etkisini araþtýrmayý amaçlamaktadýr.
Gereç ve Yöntem: Standart týbbi tedavilere yanýt vermeyen ve 10 günlük aralýklarla altý seans bilateral transnazal SPGB geçiren fibromiyalji hastalarýnýn Ocak-Mayýs 2021 arasýnda Algoloji polikliniðine baþvuran hastane kayýtlarý retrospektif olarak incelendi. Numerical Rating Skala (NRS), fonksiyonel kapasite Fibromiyalji Etki Anketi (FIQ), uyku durumu Pittsburgh Uyku Kalitesi Ýndeksi (PSQI) ve depresyon þiddeti Beck Depresyon Envanteri (BDI) verileri tedavi sürecinde toplandý.
Bulgular: Tedavi öncesinde hastalarýn ortalama NRS skoru 8.1852±1.71053 iken, tedaviden sonra 6.2593±2.29703 idi. Tedavi öncesi hastalarýn ortalama FIQ skoru 73.0359±13.55302 iken, tedaviden sonra 54.2507±16.1906 idi. Tedavi sonrasýnda, hastalarýn aðrý skoru, fonksiyonel kapasite, uyku kalitesi ve depresyonu tedavi öncesi ile istatistiksel olarak önemli farklýlýk gösterdi (p<0.001).
Sonuç: SPGB’nin, fibromiyalji hastalarýnda aðrý, fonksiyonel kapasite, uyku bozukluklarý ve depresyonu olumlu yönde etkilediði bulunmuþtur.

Objectives: The Sphenopalatine Ganglion (SPG) is the target of interventional procedures in musculoskeletal pain, especially headaches, due to its role in the autonomic nervous system. Our study aimed to investigate the effect of transnasal sphenopalatine ganglion blockade (SPGB) on pain, functional capacity, sleep, and depression in fibromyalgia patients.
Methods: The hospital records of fibromyalgia patients who applied to the Algology outpatient clinic between January and May 2021, unresponsive to standard medical treatments, and underwent six sessions of bilateral transnasal SPGB at 10-day intervals were analyzed retrospectively. Numerical Rating Scale (NRS), functional capacity Fibromyalgia Impact Questionnaire (FIQ), sleep status Pittsburgh Sleep Quality Index (PSQI), and depression severity Beck Depression Inventory (BDI) data were collected during the treatment process.
Results: The mean NRS score of the patients before the treatment was 8.1852±1.71053, compared with 6.2593±2.29703 after the treatment. The mean FIQ score of the patients before the treatment was 73.0359±13.55302, compared with 54.2507±16.1906 after the treatment. After the treatment, the pain score, functional capacity, sleep quality, and depression of the patients were statistically significantly different than pretreatment (p<0.001).
Conclusion: SPGB has been found to positively affect pain, functional capacity, sleep disorders, and depression in patients with fibromyalgia.

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Amaç: Bu çalýþmanýn amacý, osteoartrit tedavisinde diz eklemine enjekte edilen otolog yað dokusunun güvenilirliðini ve etkinliðini deðerlendirmektir.
Gereç ve Yöntem: Diz osteoartriti için intraartiküler otolog yað dokusu enjeksiyonu yapýlan 165 hastayý inceledik. Tedavinin etkinliði 1, 3, 6 ve 12 aylýk takiplerde Vizüel Analog Skala (VAS), Western Ontario ve McMaster Üniversiteleri Osteoartrit Ýndeksi (WOMAC) ve Oxford Diz Skoru (OKS) kullanýlarak deðerlendirildi. Diz artritli hastalar Kellgren-Lawrence (K-L) skalasýna göre evre I-IV olarak sýnýflandýrýldý. Hastalarýn klinik ve demografik bilgileri, NSAÝÝ veya opioid kullanýmý ve iþleme iliþkin yan etkiler kaydedildi.
Bulgular: 62 erkek ve 103 kadýn hasta mevcuttu. Ortalama yaþ 61,28±11,4 yýl ve ortalama VKÝ 26,23±4,49 idi. K-L evre I-III osteoartriti olan hastalarýn VAS, WOMAC ve OKS deðerlerinde anlamlý bir iyileþme (p<0.001) gözlendi. K-L evre IV osteoartriti olan hastalar istatistiksel olarak anlamlý bir iyileþme göstermedi. Hastalarda ciddi bir komplikasyon gözlenmedi. Ayrýca, günlük parasetamol/tramadol dozlarýnda ve 12 aylýk izlemde NSAÝÝ kullanmaya devam eden hasta sayýsýnda istatistiksel olarak anlamlý azalma saptandý.
Sonuç: Çalýþmanýn sonuçlarý, minimal manipüle edilmiþ otolog yað dokusu enjeksiyonunun evre I-III diz osteoartriti mevcut hastalarda etkili ve güvenli bir tedavi yöntemi olduðunu düþündürmektedir. Þiddetli osteoartritte sýnýrlý iyileþtirme yeteneði nedeniyle sonuçlar tatmin edici olmayabilir.

Objectives: The purpose of this study was to evaluate the safety and efficacy of autologous fat tissue injection into the knee joint for the treatment of osteoarthritis.
Methods: We reviewed 165 patients who received an intra-articular injection of autologous fat tissue for knee osteoarthritis. The efficacy of the treatment was evaluated at 1, 3, 6, and 12 months follow-up using the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Oxford Knee Score (OKS). Patients with knee arthritis were classified as grades I-IV according to the Kellgren-Lawrence scale (K-L). The clinical and demographic information of the patients, NSAIDs or opioid use, and the side effects related to the procedure were recorded.
Results: There were 62 male and 103 female patients. The mean age was 61.28±11.4 years, and the mean BMI was 26.23±4.49. A significant improvement (p<0.001) was observed in VAS, WOMAC, and OKS values of patients with K-L grade I-III osteoarthritis. Patients with K-L grade IV osteoarthritis showed no statistically significant improvement. No serious complications were observed in the patients. In addition, a statistically significant decrease was found in the daily doses of paracetamol/tramadol and in the number of patients who continued to use NSAIDs after 12 months of follow-up.
Conclusion: The results of the study suggest that minimally manipulated autologous fat tissue injections are effective and safe treatment methods for patients with grade I-III knee osteoarthritis. The results may not be satisfactory in severe osteoarthritis due to the limited capabilities.

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Amaç: Bu çalýþmanýn amacý, hastane çalýþanlarýnda bel aðrýsý sýklýðýný ve bel aðrýsý ile kiþisel ve mesleki risk faktörleri arasýndaki iliþkiyi incelemektir.
Gereç ve Yöntem: Araþtýrmanýn örneklemini bir üniversite hastanesinde çalýþan 270 hemþire ve 189 hasta bakýcý oluþturmaktadýr. Demografik özellikler, bel aðrýsý öyküsü ve bel aðrýsý risk faktörleri kiþisel bildirim anketleri ile sorgulandý. Gövde ekstansör kaslarýnýn dayanýklýlýðýný deðerlendirmek için Biering-Sorensen Testi kullanýldý. Ayrýca Oswestry Engellilik Ýndeksi (ODI) ve Hastane Anksiyete ve Depresyon Ölçeði (HADÖ) kullanýldý.
Bulgular: Çalýþmaya alýnan hastane çalýþanlarýnýn %56.5’inde son bir ayda bel aðrýsý, %81,9’unda ise bel aðrýsý öyküsü vardý. Stresli bir çalýþma ortamýnda çalýþanlarda, uzun süre ayakta duranlarda, hasta veya aðýr nesneleri kaldýrma aracý kullanmadan kaldýranlarda ve hastalarý tek baþýna nakledenlerde bel aðrýsý sýklýðý anlamlý olarak daha yüksekti. Ayrýca, düzenli spor yapan ve iþinden memnun olanlarýn bel aðrýlarýnýn anlamlý olarak daha az olduðu belirlendi (p<0.05). Biering-Sorensen testi orta-lamasýnda iki grup arasýndaki fark istatistiksel olarak anlamlýydý (p<0.001). Bel aðrýsý olan ve olmayan gruplar arasýnda HAD-Anksiyete ve HAD-Depresyon alt ölçek puanlarý arasýnda anlamlý fark vardý.
Sonuç: Araþtýrma bulgularý, hastane çalýþaný olmanýn bel aðrýsý için bir risk faktörü olduðunu ve bel kaslarýnýn kuvvet ve dayanýklýlýðýndaki azalmanýn bel aðrýsý riskini artýrdýðýný göstermiþtir.

Objectives: The objective of this study is to investigate the frequency of low back pain and the relationship between low back pain and personal and occupational risk factors in hospital employees.
Methods: The study sample consisted of 270 nurses and 189 caregivers working in a university hospital. Demographic characteristics, low back pain history, and low back pain risk factors were queried by self-report questionnaires. The Biering-Sorensen Test was used to evaluate the endurance of trunk extensor muscles. Also, the Oswestry Disability Index (ODI) and Hospital Anxiety and Depression Scale (HADS) were used.
Results: Of the hospital employees included in the study, 56.5% had low back pain in the last month, and 81.9% had a his-tory of low back pain. The frequency of low back pain was significantly higher among those who work in a stressful working environment, stand for extended periods, lift patients or heavy subjects without using a lifting device, and transfer patients alone. In addition, it was determined that those who exercise regularly and are satisfied with their job had significantly less low back pain (p<0.05). The mean Biering-Sorensen test difference between the two groups was statistically significant (p<0.001). There was a significant difference between the groups with and without low back pain in terms of HADS-Anxiety and HADS-Depression subscale scores.
Conclusion: The study findings indicated that being a hospital worker is a risk factor for low back pain, and the decrease in the strength and endurance of the lower back muscles increases the risk of low back pain.

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Amaç: Bu araþtýrmanýn amacý, hemþirelerin aðrý yönetiminde etik tutumlarýnýn belirlenmesi için “Hemþirelikte Aðrý Yönetiminde Etik Tutum Ölçeði”nin geliþtirilmesidir.
Gereç ve Yöntem: Araþtýrmanýn evrenini, Ýzmir iline baðlý bir üniversite hastanesinde görev yapan hemþireler (n=411) oluþturmuþtur. Hemþirelikte Aðrý Yönetiminde Etik Tutum Ölçeði, araþtýrmacýlar tarafýndan “Bakým ve Onur,” “Etik Deðerler,” “Tutum,” “Haklar” ve “Aðrý Yönetimi” olmak üzere beþ alt boyutta, literatürde yer alan hemþirelikte aðrý yönetimi ile ilgili pek çok araþtýrma incelenerek ve uzman görüþleri alýnarak geliþtirilmiþtir. Ýlk geliþtirildiðinde 36 maddeden oluþan taslak ölçek, uzman görüþleri ve geçerlik analizleri sonucunda önce 34 maddelik þeklini almýþ, sonrasýnda yapýlan geçerlik güvenirlik analizleri neticesinde 23 maddeden oluþmuþtur. Bu baðlamda; ölçeðin geliþtirilmesinde “Açýmlayýcý Faktör Analizi, Doðrulayýcý Faktör Analizi, Barlett Testi, Ki-Kare Uyum Testi, Cronbach Alfa Testi, Shapiro-Wilk Testi, Hotelling’s T Testi, Spearman Brown Katsayýsý, Guttman Split-Half Coefficient Testi, ROC Eðrisi Analizi” kullanýlmýþtýr.
Bulgular: Ölçeðin toplam Cronbach alfa deðeri 0.862 olarak belirlenirken; faktörlere ait Cronbach alfa deðerleri incelendiðinde ise sonuçlar: “Bakým ve Onur” alt boyutuna ait Cronbach alfa katsayýsý deðeri 0.889; “Etik Deðerler” alt boyutuna ait Cronbach alfa katsayýsý deðeri 0.838; “Tutum” alt boyutuna ait Cronbach alfa katsayýsý deðeri 0.861; “Haklar” alt boyutuna ait Cronbach alfa katsayýsý deðeri 0.795; “Aðrý Yönetimi” alt boyutuna ait Cronbach alfa katsayýsý deðeri 0.721 olarak saptanmýþtýr.
Sonuç: Bu veriler doðrultusunda, “Hemþirelikte Aðrý Yönetiminde Etik Tutum Ölçeði”nin geçerli ve güvenilir bir ölçek olduðu belirlenmiþtir.

Objectives: The aim of this study is to develop the “Developing an Ethical Attitude Scale for Pain Management in Nursing” to assign the ethical attitudes of nurses in pain management.
Methods: The population of the study comprised nurses (n=411) working in a university hospital in Ýzmir. The Ethical Attitude Scale in Nursing Pain Management was developed in five sub-dimensions: “Care and Dignity,” “Ethical Values,” “Attitude,” “Rights,” and “Pain Management.” This scale was created by examining many research studies related to pain management in nursing in the literature and taking expert opinions. “The Ethical Attitude Scale in Nursing Pain Management” initially consisted of 36 items. After expert opinions and validity analyses, the draft scale was reduced to 34 items, and then reliability analysis further reduced the scale to 23 items.
Results: In the validity and reliability study of “The Ethical Attitude Scale in Nursing Pain Management,” the total Cronbach’s alpha value of the scale was 0.86. The Cronbach’s alpha value for the “Care and Dignity” sub-dimension was 0.88; for the “Ethical Values” sub-dimension, it was 0.83; for the “Attitude” sub-dimension, it was 0.86; for the “Rights” sub-dimension, it was 0.79; and for the “Pain Management” sub-dimension, it was 0.72.
Conclusion: According to these data, it was determined that “The Ethical Attitude Scale in Nursing Pain Management” is a valid and reliable scale.

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Kanser, sistemik ve ilerleyici bir hastalýktýr. Aðrý, hastalar için ciddi bir problemdir. Kordotomi, dirençli kanser aðrýsý için en etkili tedavi yöntemlerinden biridir. Bilateral perkütan servikal kordotomi, bilateral ekstremite aðrýsý olan hastalarda yapýlabilir. Buna göre, bu olgu sunumunda, yumuþak doku sarkomlu 69 yaþýnda bir kadýn olgu temelinde dirençli kanser aðrýsýnýn tedavisinde bilateral servikal perkütan kordotomi kullanýmý tartýþýlmýþtýr.

Cancer is a systemic and progressive disease, and pain is a serious problem for patients. Cordotomy is one of the most effective treatments for refractory cancer pain. Bilateral percutaneous cervical cordotomy can be performed in patients with bilateral extremity pain. Accordingly, this case report discusses the use of bilateral cervical percutaneous cordotomy in the treatment of refractory cancer pain based on a 69-year-old woman with soft tissue sarcoma.

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Batý Nil virüsü (BNV) enfeksiyonu, doðal konaðý olan vahþi kuþlardan sivrisinekler aracýlýðýyla insanlara bulaþan ve genellikle asemptomatik seyir gösteren bir klinik tablodur. Semptomatik olan bireylerde sýklýkla gribal enfeksiyon benzeri BNV ateþi görülmekte, daha nadiren ise nöroinvazif seyir izlenmektedir. Nöroinvazif BNV, geniþ spektrumlu bir nörolojik belirti ve bulgu profiline sahiptir. BNV menenjiti, en sýk görülen nöroinvazif BNV formlarýndan biridir ve diðer viral menenjitlerden klinik ve radyolojik olarak belirgin farklýlýðý bulunmamaktadýr. Primer baþ aðrýlarýný taklit edebilen sekonder baþ aðrýlarý etiyolojisinde, özellikle yaz aylarýnda baþvuran olgularda akýlda tutulmasý gereken bir enfeksiyon etkenidir. Bu çalýþmada migrenöz karakterde baþ aðrýsýyla prezente olan BNV menenjiti vakasý sunulmuþtur.

West Nile Virus (WNV) infection is a clinical picture that is transmitted from wild birds, its natural host, to humans through mosquitoes and generally shows an asymptomatic course. Influenza-like WNV fever is frequently seen in symptomatic individuals, and a neuroinvasive course is more rarely observed. Neuroinvasive WNV has a broad-spectrum profile of neurological signs and symptoms. WNV meningitis is one of the most common neuroinvasive forms of WNV, and it does not differ clinically and radiologically from other viral meningitis. Secondary headaches, which can mimic primary headaches, are an infectious factor that should be kept in mind in the etiology, especially in cases presenting in the summer months. In this study, a case of WNV meningitis presenting with a headache of migrainous character is presented.

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Osteitis pubis (OP), pubik kemiði, simfizisi ve komþu yapýlarý etkileyen nadir görülen inflamatuvar bir hastalýktýr. OP, ürolojik ve jinekolojik cerrahi sonrasý ve sporcularda bildirilmiþtir. OP kendi kendini sýnýrlayan bir durumdur ancak bazen semptomlar uzun süre devam edebilir. OP genellikle konservatif yöntemler ile tedavi edilebilir. Burada floroskopi rehberliðinde steroid enjeksiyonu ile tedavi edilen bir hastayý bildirdik. 63 yaþýndaki erkek hastada prostat cerrahisi sonrasý nonsteroid antiinflamatuvar ilaçlara dirençli pelvik aðrý geliþmiþti. Floroskopi altýnda steroid enjeksiyonu yapýlan hastanýn günlük yaþam aktivitelerini ve yürümeyi etkileyen aðrýlarý üç ay boyunca hafifletildi.

Osteitis pubis (OP) is a rare, inflammatory disorder that affects the pubic bone, symphysis, and adjacent structures. OP is reported after urological and gynecological surgeries and documented in athletes. OP is a self-limiting condition, but sometimes symptoms may persist for a long time. Conservative modalities are generally able to treat OP. Here we report a patient treated with a steroid injection under fluoroscopy guidance. A 63-year-old male patient developed pelvic pain after prostate surgery, and the pain was intractable to non-steroidal anti-inflammatory drugs. He underwent a steroid injection under fluoroscopy, and his pain affecting daily living activities and walking was eased for three months.

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