AIm:The study was conducted to compare the clinical effectiveness of FJ injections (FJI) and FJ radiofrequency (FJRF) denervation in patients with chronic low back pain. mAterIAl and methOds:This study included 100 patients; 50 in FJI 50 in FJRF group. VNS, NASS and EQ-5D were used to evaluate the outcomes. All outcome assessments were performed at baseline, 3 months, 6 months and 12 months. results: FJI in early post-op but FJRF in 1st, 6th and 12th month VNS showed better results (p<0.001). There was no significant difference in the 1st (p=1) and 6th month (p=0.13) but in 12th month (p=0.04) in NASS. Increase in level number showed positive effect in NASS in FJRF group (p=0.018) but no effect in FJI group (p=0.823) in the 12th month follow-up. There was no significant difference with respect to 1st month (p=0.17), 6th month (p=0.22) and 12th month (p=0.11) post-procedure follow-ups in EQ-5D. At the short term FJI was more effective than FJRF however in midterm follow-up FJRF had more satisfying results than FJRF.COnClusIOn: To our knowledge, the first choice should be the FJI and if pain reoccurs after a period of time or injection is not effective, RF procedure should be used for the treatment of chronic lumbar pain.KeywOrds: Facet, Joint, Injection, Radiofrequency, Denervation, Low back pain ÖZ AmAÇ: Lomber faset eklem (FE) bozuklukları kronik bel ağrılarının en sık sebebidir. Bu çalışmada, kronik bel ağrılı hastalarda uygulanan FE enjeksiyonu (FEE) ve radyofrekans denervasyonunun (FER) klinik sonuçlarının karşılaştırılması amaçlamaktadır. yÖntem ve GereÇler: Bu çalışmaya 50 FEE ve 50 FER yapılan 100 hasta dahil edildi. VNS, NASS ve EQ-5D sonuçların değerlendirilmesi amacıyla kullanıldı. Sonuçlar başlangıç, 3. ay, 6. ay ve 12. aylarda elde edildi.BulGulAr: FEE işlem sonrası erken dönemde, FER ise 1., 6. ve 12. ayda daha etkiliydi (p<0,001). NASS sonuçlarında 1. (p=1) ve 6. ayda (p=0.13) anlamlı fark yokken 12. ayda (p=0,04) vardı. İşlem yapılan segment sayısı FER grubunun (p=0,018) 12. aydaki NASS sonucunu pozitif yönde etkilerken FEE grubunda (p=0,823) etkisi yoktu. EQ-5D sonuçları açısından 1. (p=0,17), 6. (p=0,22) ve 12. ayda (p=0,11) iki grup arasında anlamlı fark saptanmadı. Kısa dönemde FEE daha etkiliyken orta dönemde FER'in sonuçları daha başarılıydı. sOnuÇ: Faset eklemden kaynaklanan bel ağrılarında, FEE ve FER birer tedavi seçenekleridir. Sonuçlarımıza göre, kronik bel ağrısının tedavisinde FEE ilk seçenek olarak düşünülmeli ve bir süre sonra tekrarlayan veya FEE etkili olmadığı durumlarda FER tedavi amacıyla kullanılmalıdır.

Intervertebral disk (IVD) degeneration is a common, chronic, and complex degeneration process that frequently leads to back pain and disability, resulting in a major public health issue. In this review we describe biological therapies under preclinical or clinical development with an emphasis on stem cell-based multimodal approaches that target prevention and treatment of IVD degeneration. Systematical review of the basic science and clinical literature was performed to summarize the current status of devising biological approaches to treating IVD degeneration. Since the exact mechanisms underlying IVD degeneration have not yet been fully elucidated and conservative managements appear to be mostly ineffective, current surgical treatment focuses on removal of the pathological disk tissues combined with spinal fusion. The treatment options, however, often produce insufficient efficacy and even serious complications. Therefore, there have been growing demands and endeavors for developing novel regenerative biology-guided strategies for repairing the IVD via delivery of exogenous growth factors, introduction of therapeutic genes, and transplantation of stem cells, or combinatorial therapies. Overall, the data suggest that when applied under a recovery neurobiology principle, multimodal regimens comprising ex vivo engineered stem cell-based disks hold a high potential promise for efficacious clinical translations.

Carpal tunnel syndrome (CTS) is a common focal peripheral neuropathy. Increased pressure in the carpal tunnel results in median nerve compression and impaired nerve perfusion, leading to discomfort and paresthesia in the affected hand. Surgical division of the transverse carpal ligament is preferred in severe cases of CTS and should be considered when conservative measures fail. A through knowledge of the normal and variant anatomy of the median nerve in the wrist is fundamental in avoiding complications during carpal tunnel release. This paper aims to briefly review the anatomic variations of the median nerve in the carpal tunnel and its implications in carpal tunnel surgery. KeywOrds: Median nerve, Anatomic variation, Carpal tunnel, Transverse carpal ligament ÖZKarpal tünel sendromu (KTS) sık görülen bir periferik nöropatidir. Karpal tünel basıncının artması median sinirin sıkışmasına ve kanlanmasının bozulmasına yol açar. Ağır vakalarda ve konservatif tedavinin yeterli olmadığı durumlarda cerrahi olarak transvers karpal ligamanın kesilmesi tercih edilir. Karpal tünelin gevşetilmesi sırasında komplikasyonlardan kaçınmak için median sinirin bu bölgedeki ayrıntılı anatomisinin ve varyasyonlarının iyi bilinmesi gereklidir. Bu derleme median sinirin karpal tüneldeki olası anatomik varyasyonlarını ve bunun karpal tünel cerrahisine etkilerini kısaca gözden geçirmek amacıyla yazılmıştır.

Almost the same clinical outcomes can be achieved with and without duroplasty. There might be an option to perform duroplasty if simple procedure fails.

This retrospective study summarizes our experience based on treating 62 patients with trigeminal neuralgia treated with microvascular decompression. All patients had typical trigeminal neuralgia symptoms, with 24 of them (38%) having failed to benefit from other previous treatment paradigms. We excluded subjects with atypical and/or secondary forms of trigeminal neuralgia. Follow-up duration ranged from 5 months to 10 years 6 months, with recurrence being identified in three patients (4.8%).We found that the superior cerebellar artery is the leading offending vessel in our cases (33.9%; 21 patients). Interestingly, seven patients (11.3%) underwent an early reoperation 12-48 h later after the first operation was deemed ineffective. This subgroup recovered satisfactorily following isolation of the pathogenic vessels. Overall, no mortality was observed in our patients, and the only permanent morbidity outcome was a case of facial nerve palsy (1.6%). We conclude that microvascular decompression and its reapplicaiton for patients who showed no pain relief immediately after the first decompression are safe and effective treatments for trigeminal neuralgia.

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If the patients experience severe or mild back pain with higher preoperative KA, especially in the first 2 months, then they deserve detailed radiologic examination. To avoid subsequent fracture in the same or adjacent level, vertebral body should be filled adequately and sagittal balance should be obtained with KA correction. BK alone did not influence the incidence of subsequent VCF.

Our data suggest that RFT destruction of ganglion impar in patients with chronic coccydynia has an effective outcome and patients responding to RFT have significantly lower post-RFT pain scores. The most important factors determining success of this procedure is strict patient selection criteria and the technique of the procedure.