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    Comparison of Local Steroid Injection and Pulsed Radiofrequency Neuromodulation for the Treatment of Mild Idiopathic Carpal Tunnel Syndrome
    (JOURNAL NEUROLOGICAL SCIENCES, 2016) Suslu, Husnu; Turan Suslu, Hikmet; Guclu, Bulent; Ozdogan, Selcuk; Duzkalir, Ali Haluk; Karabagli, Hakan
    Aim: The aim of this study was to compare the effectiveness of local steroid injection and pulsed radiofrequency neuromodulation for the treatment of mild idiopathic carpal tunnel syndrome. Methods: Fifty-nine patients investigated retrospectively. The results of local steroid injection for the treatment of idiopathic carpal tunnel syndrome in 28 patients were compared with pulsed radiofrequency neuromodulation in 31 patients. The visual analogue scale and neuropathic pain scale scores were evaluated before and 1, 3 and 6 months after treatment in both groups. Results: Following the procedure, each patient reported an absence of pain, disappearance or reduction of paraesthesia and improvement in hand function. At 1, 3 and 6 months after the procedure, there was significant improvement in visual analog scale and neuropathic pain scale scores compared to the preprocedure states in both groups. The improvement rates of preprocedure and postprocedure visual analog scale scores and neuropathic pain scale scores were similar for both groups except postprocedure sixth month scores. There was a statistically significant difference in neuropathic pain scale scores at postoperative sixth month between the local steroid injection and pulsed radiofrequency neuromodulation groups so that local steroid injection reported more effective. Conclusion: Local steroid injection gives better long-term results than pulsed radiofrequency neuromodulation for the treatment of idiopathic carpal tunnel syndrome.
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    Influence of Prior Lumbosacral Surgery on The Incidence of Intravascular Injection During Transforaminal Epidural Injections
    (JOURNAL NEUROLOGICAL SCIENCES, 2015) Suslu, Husnu; Suslu, Hikmet Turan; Tatarli, Necati; Ceylan, Davut; Guclu, Bulent; Karabagli, Hakan
    Objective: Percutaneous lumbar transforaminal epidural steroid injections are frequently used to treat low back pain. However, many reports have indicated that this procedure has a high risk of morbidity. The aim of this study was to determine the difference in the incidence of vascular penetration during lumbosacral transforaminal epidural injections between patients with previous lumbar spinal surgery and patients who did not undergo surgery. Design: This is a prospective clinical study. Methods: In this study, patients who received lumbar transforaminal epidural injections at an outpatient spine center were included and followed. An interventional spine physician observed fluoroscopically guided lumbosacral transforaminal epidural steroid injections under live fluoroscopy and recorded contrast patterns. A total of 296 fluoroscopically guided lumbosacral transforaminal epidural steroid injections under live fluoroscopy in 108 patients were evaluated. Results: The incidence of vascular contrast patterns was observed under live fluoroscopy. Vascular injections were observed in 28 of the 296 injections, for an overall incidence of 9.5%. The incidence of intravascular injections among patients was 40.0% (20/50) in the previously operated group and 13.8% (8/58) in the non-operated group. This difference was statistically significant (p<0.001). A secondary analysis was performed to determine if the other factors affected the success of the procedure or increased the incidence of vascular injections. Conclusion: Our results indicated that previous surgery affected intravascular dissemination and increased the risk of vascular injection. Cohesional area caused by previous surgery complicated the injection. Additionally, fluoroscopy count and operation time were also affected by previous surgery.
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    Percutaneous radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: Experience in 106 patients
    (EGE UNIV, 2018) Suslu, Husnu; Suslu, Hikmet Turan; Ozdogan, Selcuk; Guclu, Bulent; Duzkalir, Ali Haluk
    Objective: The aim of our study is to analyse the results of percutaneous radiofrequency trigeminal rhizotomy for treatment of idiopathic trigeminal neuralgia. Methods: We inspected the results of 106 patients with the diagnoses of idiopathic neuralgia that treated with percutaneous radiofrequency trigeminal rhizotomy retrospectively. The scores of visual analog scale(VAS) were noted preoperative and postoperative periods at 1st, 3rd, 6th and 12th months and were used for statistical analysis. Results: Mean age of 106 patients was 67.31 +/- 8.85 years. Duration of symptoms was 19.1 +/- 13.1 months. Duration of symptoms did not change significantly according to gender (p=0.755), or site of trigeminal pain (p=0.158). There was not any statistical significance between gender, effected branch of trigemial nerve and side of the pain. Preoperative mean VAS score was 9.6 +/- 0.75. Postoperative mean VAS score values were 3.25 +/- 2.44 at first month, 3.23 +/- 2.43 at third months, 3.12 +/- 2.78 at sixth months and 2.59 +/- 3.18 at postoperative twelfth months. We found statistically significant difference between preoperative and postoperative 1st, 3rd, 6th and 12th months VAS scores (p<0.001). Conclusion: Percutaneous radiofrequency trigeminal rhizotomy is the minimally invasive treatment modality with lower complication rates and it has a high rate of efficacy when compared with invasive methods. It is most cost-effective procedure to choose if the pain recurs.