Faculty of Medicine

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    Clinical Effectiveness of Single Lumbar Periradicular Infiltration in Patients with Sciatica
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2023-07-15)
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    Kostova, Masha
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    Ristikj-Stomnaroska, Daniela
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    Periradicular therapy (PRT) is a minimally invasive radiological procedurein patients with chronic lumbar pain.The aim of the study is to identify clinical and radiological predictive factors for treatment success after a single PRT treatment in patients with sciatica.The study includes a prospective follow-up of 166 patients treated with PRT. The pain intensity is determined according to the VAS scale and the degree of improvement is presented as excellent (over 75%), good (50-70%), moderate (25-49%), and weak (less than 25%). The follow up of the treated patients was done at 2 weeks, 3 and 6 months. In patients with pain duration up to 3 months, the improvement was excellent in n=32 (58.18%) after 2 weeks, after 3 months n=41 (74.55%) and after 6 months n=41 (74.55%). This stands in contrast to patients with pain over 1 year. The percentage of improvement after 6 months, post-intervention, was highest in patients without nerve root compression (86.25±19.2),and the highest improvement after 6 months was in patients with localization of pain at the L4-L5 level (69.69±29.7), the greatest improvement after six months was in patients with extraforaminal hernia (62.82±34.3), and the lowest in patients with central stenosis (40.21±30.7).Our study results suggest that the shorter a pain duration, low-grade root compression, injection level and type of herniation area predictor the more favourable response patients have to transforaminal epidural steroid injection in patients with sciatica.
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    Evaluation of the therapeutic efficacy of computed tomography - guided periradicular therapy in patients with extraforaminal disc herniations.
    (Macedonian Association of Anatomists, 2020-12-30)
    Veljanovski, Dimitar
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    Kostova, Masha
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    Periradiculartherapy (PRT) is a minimally invasive radiological technique for treatment ofchronic lumbar pain.The aim of this study was to investigate the efficacy of PRT in patients with chronic lumbar pain and radiculopathy due to extraforaminal disc herniation.The study included a prospective follow-up of 30 patients with chronic lumbar pain and radiculopathy. All patients underwentmagnetic resonance imaging (MRI) and extraforaminal neuro-radicular conflict was detected. The degree of pain intensity was scored according to the VAS scale. The degree of improvement was presented as excellent (over 75%), good (50 -70%), intermediate (25-49%) and poor (less than 25%). Functional and working status was rated according to Oswestry Disability index2.0 (ODI). Follow-up of treated patients was at 2 weeks and 3 months.After 2 weeks the improvement was excellent in14 patients (47%), good in 7 patients (23%), moderate in 7 patients (23%) and mild in 2 patients (7%). Improvement after 3 months was excellent in 15 patients (50%), good in 7 patients (23%), moderate in 3 patients (10%) and poor in 5 patients (17%). The improvement of the functional status according to the ODI score was at least 40% in 73.3% of patients after 2 weeks and 86.5% of patients after the third month.CTcontrolled PRT in patients with lumbar radiculopathy is a safe and effective procedure leading to a significant pain reduction and a better quality of life after the procedure