The assesment of pain intensity and the degree of disability after lumbar epidural steroid aplication

Ciljevi studije: Steći uvid u korisnost i napredak liječenja križobolje, boli u donjim udovima i smanjenju stupnja invalidnosti postupkom lumbalne epiduralne primjene steroida. Zaključiti na koje funkcije ispitanikova svakodnevnog života najpovoljnije utječe ova terapija te bolje predvidjeti tijek liječenja ove boli. Nacrt studije: Prospektivna kohortna studija Ispitanici i metode: Svi bolesnici koji su se podvrgavali postupku lumbalne epiduralne injekcije steroida na Klinici za anesteziologiju, reanimatologiju i intenzivno liječenje Kliničkog bolničkog centra Osijek u razdoblju od 31 dan, a pristali su na ispitivanje. Ispitano je 36 bolesnika, od toga 18 muških i 18 ženskih, prosječne starosti 62 godine. Materijal i metode: Intervju u kojem ispitivač ispitanicima postavlja pitanja iz Oswestry upitnika za procjenu invalidnosti uzrokovanu boli u lumbalnom području leđa i procjenjuje razinu boli vizualnom analognom skalom boli. Rezultati su statistički obrađeni programom MedCalc Statistical Software version 14.12.0 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014). Rezultati: Razina procijenjene boli spustila se s medijana 8 prije postupka na medijan 3 nakon postupka. Postotak invalidnosti procijenjen Oswestry upitnikom pao je sa 47,5 % prije na 24 % nakon postupka. Svih 36 ispitanika prije postupka morali su uzimati analgetsku terapiju, dok nakon postupka njih čak 14 nema potrebu za analgetskom terapijom. Zaključak: Postupak lumbalne epiduralne injekcije steroida rezultirao je značajnim smanjenjem razine boli i stupnja invalidnosti u većine ispitanika. Najveći utjecaj imao je na ispitanikovu mogućnost stajanja i spavanja dok najmanji učinak ima na podizanje teških predmeta.Study goals: The main goal of this study is to get insight into usefullness and advancements in treating lower back and lower limb pain using lumbar epidural steroid injection. The other goal is to gather data in order to show which functions of examinee's life were influenced the most by this procedure. Study design: Prospective cohort study in which a group of 36 examinees is being questioned before and two weeks after lumbar epidural steroid injection procedure. Examinees and methods: All patients who accepted to be questioned and underwent lumbar epidural steroid injection procedure at the Clinic of Anesthesiology, Reanimation and Intensive Care of the Osijek Clinical Hospital Center for 31 days. Materials and methods: The main questioning technique was an interview during which the interviewer put questions from Oswestry low back pain disability questionnaire and assessed the level of pain using visual analogue scale of pain. All results were statistically processed by the programm: MedCalc Statistical Software version 14.12.0 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014). Results: After the procedure the pain assessment level median was reduced from 8 to 3. Disability percentage assessed by using Oswestry questionnaire dropped from 47,5 % to 24 %. Out of 36 examinees which had to use analgesic therapy before the procedure, 14 of them got rid of the pain and the need to use analgetic therapy. Conclusion: For most examinees lumbar epidural steroid injection procedure resulted in significant reduction of pain and disability degree. The procedure had the strongest influence on the examinee's ability to stand and sleep, and the least influence on ability to lift heavy objects