Hacettepe Üniversitesi Ağrı Kliniğinde Sigara İçen ve İçmeyen Hastaların Kronik Bel Ağrısı Tedavisi İçin Faset Eklem Enjeksiyonundan Fayda Görme Oranının Kıyaslanması
Özet
Turana Rasulova. Comparison of benefit rate from facet joint injection therapy in smoker and non-smoker patients with chronic low back pain. Hacettepe University Faculty of Medicine, thesis in anesthesiology, Ankara, 2021.
Background and Goal of Study: In the Pain Clinic, facet joint injections are routinely performed for therapeutic purposes in patients whose low back pain are confirmed to be caused by a problem in the facet joints. In this study, we aimed to compare the rate of benefit from facet joint injection procedures in smokers and non-smokers.
Materials and Methods: Patients older than 18 years of age who underwent facet joint injection in the Pain Management Operating Room between January 1, 2019 and December 31, 2019 were included in the study. After scanning the files of the patients' demographic data and pain scores, the patients were contacted and their pre-procedure and post-procedure 6 month NRS scores, smoking histories were recorded and added to the data collection forms. The patients were asked to evaluate the pain values before and after the procedure in 5 categories, from 0 to 10, according to the NRS pain score, “0 to 2 (1) - no pain or (sometimes) very mild, 2-4 (2) - mild to moderately severe I have pain, 4-6(3) – moderate pain, 6 – 8 (4) very severe pain, 8-10 (5) – very severe and sometimes unbearable pain” were added to the database.
Results and Discussion: 234 patients were included in the statistical analysis. When we look at the age distribution of the patients, the youngest patient who underwent the procedure was 20 years old, the oldest was 90 years old, and the median age group was 60.6. According to the results of the statistical analysis we conducted to evaluate the effect of smoking on pre-procedural pain scores, no relation between smoking and pre-procedural pain was observed. (p=0.976)
When we compared the rate of benefit from the procedure after facet joint injection for the treatment of chronic low back pain caused by facet joints, there was no relationship between smoking history and post-procedure NRS scores. (p=0.649) However, unlike our pre-procedural statistical analysis results, if the sample size increases since the post-procedure p value is close to alpha, not 1, the relationship between smoking and post-procedural pain scores may be significant.
Conclusion: There was no statistically significant relationship between pre- and post-procedure pain scores and smoking history in patients with a significant decrease in pain scores after facet joint injections. According to the results of our study, facet joint injections significantly reduce the low back pain of the patients as an effective treatment method. Although the age, gender and smoking history of the patients do not have a significant effect on the pain scores before and after the procedure, it is predicted that significant results may occur in patient populations with a larger sample size.
