Ekim Can Öztürk

Istanbul Eye Hospital

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SŞ

Savaş Şencan

Marmara University

Osman Hakan Gündüz

Marmara University

Rekib Saçaklıdır

Marmara University

Habip Yılmaz

Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi

Fırat Ulutatar

Weatherford College

CŞ

Canan Şanal Toprak

Marmara University

İY

İlker Yağcı

Marmara University

Alp Eren Çelenlioğlu

Sağlık Bilimleri Üniversitesi

Damla Yürük

Memorial Ankara Hospital

Sinan Pektaş

Muğla University

Cooperative Institutions

Sağlık Bilimleri Üniversitesi

Marmara University

Istanbul University

Ministry of Health

University of Health Science

Hacettepe University

Ankara University

Gazi University

Türk Anesteziyoloji ve Reanimasyon Derneği

Eskişehir Osmangazi University

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The Impact of Vitamin D Deficiency to Treatment Success of Transforaminal Epidural Steroid Injection.

PubMed (2021)

Ekim Can Öztürk Savaş Şencan Rekib Saçaklıdır Osman Albayrak Osman Hakan Gündüz

Transforaminal epidural steroid injection (TFESI) is an interventional technique used to relieve disc herniation related back and radicular pain. Although few studies have investigated the factors predicting positive outcomes after TFESI, there is no data concerning the possible relationship between pre-procedure serum 25-hydroxyvitamin D (25(OH)D) levels and the response to TFESI.To investigate the effect of vitamin D deficiency to treatment success of fluoroscopy-guided transforaminal epidural steroid injection.A retrospective assessment.A university hospital interventional pain management center.Nine hundred forty-eight patients received lumbosacral TFESI between January 2018 and December 2019 in a university hospital pain management center and were examined retrospectively for eligibility. Clinical and demographic data; magnetic resonance imaging (MRI); pre-procedure laboratory tests, including serum 25(OH)D; pain scores at baseline, third week, and third month follow-ups were collected.A total of 83 patients were recruited and divided into 2 groups with respect to vitamin D status. The number of patients with serum 25(OH)D level below 20 ng/mL was 57 and the number of patients with serum 25(OH)D level above 20 ng/mL was 26. Treatment success rates were significantly lower in vitamin D deficient group at third week and third month (P: 0.006, P: 0.01).Retrospective nature and the absence of functional outcomes.Vitamin D deficiency is associated with a lower probability of meaningful pain relief following TFESI. It may worth assessing serum vitamin D level prior to this intervention, although prospective investigation is necessary.

Epidural steroid injection

Single Center

Radicular pain

Back Pain

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The Association Between Morphometric Features of Neural Foramen and Intervertebral Disc and Treatment Success of Lumbar Transforaminal Epidural Steroid Injection: An Observational Study

Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi (2023)

Ekim Can Öztürk Elif ZEREN Ümit Şehirli Yasin ARİFOĞLU Savaş Şencan

ABS TRACT Objective: To investigate the impact of morphometric characteristics of neural foramen (NF) and intervertebral disc (ID) on magnetic resonance imaging (MRI) to the treatment outcomes after transforaminal epidural steroid injection (TFESI).Few clinical and radiological features are suggested predicting treatment success after epidural steroid injection.However, the impact of morphometric characteristics of the relevant NF to the response to TFESI is unknown.Material and Methods: This study was carried out prospectively with the participation of 45 patients who were treated with single level TFESI to L5 nerve root.Pain intensity, disability, and depression levels were assessed at baseline, 3rd week and 3rd month.The morphometrics of the relevant NF and ID were evaluated on sagittal MRI scans and compared between patients who responded and did not respond to the treatment.Results: The interrater reliability of all morphometric measurements of NF and ID performed by 2 physicians were high or excellent.Pain, depression, and disability scores were improved significantly at 3rd month compared to baseline.No statistically significant difference was found between responders and non-responders regarding morphometric evaluation (p>0.05).Conclusion: The results of the present study indicate that MRI based morphometric parameters like disc height, pedicle length, minimum and maximum foraminal width, foraminal crosssectional area (CSA), and nerve root CSA have no effect on the efficacy of TFESI.

Intervertebral foramen

Intervertebral Disc

10.31609/jpmrs.2023-96465

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“the impact of contrast spread patterns to clinical outcomes of cervical interlaminar epidural steroid injection: an observational study.”

Turkish Neurosurgery (2023)

Ekim Can Öztürk Rekib Saçaklıdır Savaş Şencan Gulhan Ertan Osman Hakan Gündüz

To investigate the relationship between epidural contrast spread patterns, and the treatment success of cervical interlaminar epidural steroid injection (CIESI) for cervical radicular pain.A total of 76 patients aged between 20 and 60 years who had neck and unilateral upper limb pain due to a single-level disc herniation at C5-C6 or C6-C7 were included. Severity of pain and disability were assessed with Numerical Rating Scale (NRS-11) and Neck Pain Disability Scale (NPDS) at baseline, three weeks, and three months after the treatment. Contrast dispersion prior to injection of the medication was graded in anteroposterior fluoroscopic view. Treatment success was defined as a ≥50% improvement at three months in the NRS-11 scores compared to baseline.A significant improvement in pain and disability scores was observed at three months compared to baseline (p < 0.001). Treatment success was observed in 57% of the patients. The multivariate binary logistic regression analysis revealed that high initial NPDS scores, severe foraminal and central stenosis, Grade 1 contrast spread pattern were negative predictors of response to CIESI.Lateral contrast spread toward the dorsal root ganglion (DRG) and spinal nerve root of the target level was associated with more favorable clinical responses. Clinicians performing CIESIs should exert effort to administer the injectate around the DRG and spinal nerve root at the target level.

Radicular pain

Neck pain

Epidural steroid injection

Cervical radiculopathy

10.5137/1019-5149.jtn.44074-23.3

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Citations (1)

The evaluation of plain bupivacaine 0.5% and 0.25% for continuous spinal anaesthesia

Regional Anesthesia & Pain Medicine (2004)

İsmail Gökyar Ekim Can Öztürk Hülya Çelebi

Regional anaesthesia

10.1016/j.rapm.2004.07.004

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Lumbar Sympathetic Block for Intractable Lower‐Limb Postherpetic Neuralgia: Report of Two Cases

Pain Practice (2020)

Ekim Can Öztürk Savaş Şencan Osman Hakan Gündüz

Abstract Lumbar sympathetic block is a commonly used technique for sympathetically mediated pain syndromes. Postherpetic neuralgia (PHN) is also accepted to be associated with sympathetic system activation. While sympathetic blocks were utilized for upper‐extremity or face‐related PHN, there has not been any report regarding lower‐extremity PHN, as it is an uncommon region. Here, we present two cases of systemic drug‐resistant PHN in lower limb, relieved with lumbar sympathetic block. Both patients had at least 50% reduction in numeric rating scale (NRS) scores at the end of 6 months. Lumbar sympathetic block could be considered in the treatment of lower‐limb PHN. More reports and controlled trials are needed for further understanding the role of the intervention in this neuropathic pain syndrome.

Postherpetic Neuralgia

10.1111/papr.12958

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Citations (7)

Postherpetik Nevraljili Hastaların Eğitimi İçin YouTube'un Kalitesini Değerlendirmek

Cukurova Anestezi ve Cerrahi Bilimler Dergisi (2023)

Rekib Saçaklıdır Ekim Can Öztürk

Introduction: Postherpetic neuralgia (PHN) is one of the common complications of herpes virus and is the most common neuropathic pain syndrome after an infectious disease. YouTube is a widely used source for information, but the quality of YouTube videos in terms of medical content is questionable. Therefore, our aim was to evaluate the PHN-related quality of YouTube videos. Materials and Methods: This study was carried out by evaluating YouTube videos up to April 2023. A total of 65 videos were evaluated. The number of views and duration of the videos, the number of likes and views, the number of comments, the age of the videos and the source of the videos were recorded. We evaluated all videos for overall educational quality and creator bias. Content creators were categorized as physicians, health-related websites, and patients, and we compared overall DISCERN scores and bias scores between creator type and search term. Results: The average view count of the videos was 119224.62. The mean DISCERN and DISCERN Bias Scores were 2.01 and 2.14 respectively. Most of the videos were uploaded by the physicians. The DISCERN and DISCERN Bias scores were significantly higher in the videos uploaded by physicians (p

Postherpetic Neuralgia

10.36516/jocass.1282387

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Proposed Ionizing Radiation Doses of 3711 Fluoroscopy-Guided Epidural Injections

Authorea (Authorea) (2021)

Rekib Saçaklıdır Ekim Can Öztürk Savaş Şencan Osman Hakan Gündüz

Background: Since fluoroscopy-guided interventional therapies grew significantly in recent years, exposure to ionizing radiation (IR) either for patient or medical staff became a critical issue. IR exposure varies according to the physicians’ experience, patients’ body mass index (BMI), imaging techniques and type of the procedure performed. The purpose of this study is to calculate the reference IR doses for fluoroscopy-guided epidural injections per procedure and BMI to provide reference doses for potential use in future dose reduction strategies. Methods: A retrospectively, evaluation of patients who received epidural steroid injections between January 2015 and December 2020 in a university hospital interventional pain management center, was performed. This observational study was conducted with patients aged  18 who underwent 3711 epidural injections including cervical interlaminar, lumbar interlaminar, lumbar transforaminal and caudal approaches. Provided IR doses for each patient were also divided by patients’ BMI to obtain dose per BMI. Results: The highest IR dose per procedure was found in caudal epidural injection with 0.218 mGy m2 and lowest dose was in cervical interlaminar epidural injection with 0.057 mGy m2. The IR dose per procedure was 0.123 mGy m2 for lumbar transforaminal and 0.191 mGy m2 for lumbar interlaminar epidural injection. Caudal epidural injection had also the highest IR dose per BMI which was 0.00749 and cervical interlaminar epidural injection had the lowest radiation dose per BMI which was 0.00214. Conclusions: We proposed reference IR dose levels of four approaches of epidural injections obtained from 3711 injections performed in a university hospital pain medicine clinic. BMI of patients were taken into account with the dose levels of injections given per BMI. Multicenter research with standardized techniques will assure more reliable reference levels which will guide pain physicians to self-assess their own levels of radiation exposure.

Epidural steroid injection

10.22541/au.161545792.21587393/v1

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Assessment of the validity and reliability of the Jenkins Sleep Scale in ankylosing spondylitis

International Journal of Rheumatic Diseases (2018)

Mehmet Tuncay Duruöz Fırat Ulutatar Ekim Can Öztürk Çağrı Ünal-Ulutatar Canan Şanal Toprak

Abstract Aim Ankylosing spondylitis (AS) affects sleep quality. Jenkins Sleep Scale (JSS) Evaluation Questionnaire is a simple and easy to understand scale. The aim of this study is to constitute validity and reliability of JSS‐TR in AS patients. Methods Jenkins Sleep Scale was translated and culturally adapted by using guidelines. Clinical and demographic data of AS patients were noted. Correlations with other functional parameters such as Multidimensional Assessment of Fatigue (MAF) scale, Ankylosing Spondylitis Quality of Life (ASQoL), Pittsburgh Sleep Quality Index (PSQI) were used to assess convergent validity of JSS‐TR (Turkish version). Discriminant validity was also assessed. Shapiro‐Wilk test was used as a test of normality. Spearman's rank correlation coefficient (rho) was used to assess the relation. Results Sixty patients (24 female and 36 male) with mean age of 39.6 ± 10.8 years were recruited. The JSS‐TR took an average of 1.5 minutes (±30 seconds) to complete. JSS‐TR had the strongest correlation with PSQI scores ( ρ = 0.75) and moderate‐strong correlations with MAF, ASQoL, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores. There was insignificant correlation with non‐clinical parameters. Conclusions JSS‐TR is a valid, simple and feasible sleep instrument that can be easily applied to AS patients both in research and clinical settings.

Rank correlation

Discriminant validity

Validity

Convergent validity

10.1111/1756-185x.13447

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Citations (26)

Letter to the Editor Regarding “Novel Method for S1 Transforaminal Epidural Steroid Injection”

World Neurosurgery (2020)

Ekim Can Öztürk Savaş Şencan Osman Hakan Gündüz

10.1016/j.wneu.2019.12.049

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Does the presence of neuropathic pain affect the outcomes of the interlaminar epidural steroid injection for cervical disc herniation?

Medicine (2021)

Canan Şanal Toprak Ekim Can Öztürk Feyza Nur Yücel Savaş Şencan Osman Hakan Gündüz

Abstract Epidural steroid injections (ESI) are commonly performed for the treatment of chronic cervical disc herniation (CDH). Although they are considered to be effective for both nociceptive and neuropathic types of pain, there is a lack of data regarding the impact of neuropathic pain (NP) and nociceptive pain components on treatment outcomes. The aim of this study is to compare the effectiveness of interlaminar epidural steroid injection (ILESI) between patients with predominantly NP and nociceptive pain due to CDH. Sixty five participants were initially included in the study and assessed by numeric rating scale (NRS), neck pain and disability scale (NPDS), short form-12 (SF-12), and self-reported Leeds assessment of neuropathic symptoms and signs (S-LANSS) pain scale at baseline and 1 month, 3 months, 6 months after ILESI. All patients were evaluated at 1st month and 3rd month follow-up periods while 54 of patients achieved to complete 6th month follow-up. There were significant improvements in all outcome measures for all time periods when compared with the pre-intervention scores. At baseline 24 (36.9%) of patients had predominantly NP in accordance with S-LANSS pain scale. The ratio of NP predominant patients reduced to 7.6% at 1st month, 12.3% at 3rd month, and 12.9% at 6th month with a significant difference for each follow-up period when compared with the baseline. Although all NRS and NPDS scores at baseline were significantly higher in patients with NP, improvement was significant at all follow-up periods in both groups. Minimal clinically important change in NRS was observed in >75% of patients at 1st, 3rd, and 6th month in both groups. The results of this study showed that NP is present in one-third of the patients suffering from neck and radiating arm pain due to CDH and cervical ILESI is an effective treatment approach for both neuropathic and nociceptive components of pain. Clinical Trials Registration Number: NCT04235478

Epidural steroid injection

Neck pain

10.1097/md.0000000000025012

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Citations (6)