Affiliations: [a] Pain Management Section, Department of Physical Medicine and Rehabilitation, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey | [b] Pain Management Section, Department of Physical Medicine and Rehabilitation, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey | [c] Physical Medicine and Rehabilitation, Istanbul Medicine Hospital, Istanbul, Turkey | [d] Pain Medicine Section, Department of Physical Medicine and Rehabilitation, Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
Correspondence:
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Corresponding author: Rekib Sacaklidir, Pain Management Section, Department of Physical Medicine and Rehabilitation, Sisli Hamidiye Etfal Training and Research Hospital, Huzur Mah. Cumhuriyet ve Demokrasi Cad. No. 1, Sarıyer, Istanbul, Turkey. E-mail: rakipsacakli@hotmail.com.
Abstract: BACKGROUND: Human assumed central sensitization (HACS) is a potential pathophysiological mechanism underlying a group of musculoskeletal disorders. HACS may negatively influence the outcomes of surgical or interventional procedures. OBJECTIVE: The present study aimed to investigate the impact of HACS on treatment outcomes of transforaminal epidural steroid injection (TFESI). METHODS: Patients who received fluoroscopy-guided single-level lumbosacral TFESI between January 2020 and January 2021 were included in the study. The patients were divided into two groups with respect to the existence of HACS. Patients were assessed before the procedure, at the third week, and at the third month after the procedure. The presence of HACS was investigated by central sensitization inventory (CSI). The Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), and Beck Depression Inventory (BDI) were used for patient assessment. RESULTS: A total of 65 patients were included in the study. Thirty-one of the patients had HACS. There was no difference between the groups in terms of demographic data. Significant improvement in NRS was found at 3rd week and 3rd month compared to the baseline. BDI and ODI scores were also significantly reduced at the end of 3 months (p< 0.001). NRS scores at all time points were significantly lower in patients without HACS (p< 0.05). CONCLUSION: The presence of HACS has a negative effect on pain scores, disability, and mental state in patients undergoing TFESI.
Keywords: Lumbar disc herniation, epidural injections, central sensitization, central sensitization inventory
