Yapay Zeka Hızlı Bakış & Çıkarımlar
AI InsightProspective controlled studies are warranted.
📌 3 Maddede Bu Makale
Abstract
Aims: To evaluate clinical outcomes, patient-reported global improvement, and documented adverse events associated with thoracic interlaminar epidural steroid injections in a real-world cohort with chronic thoracic pain, predominantly postherpetic neuralgia (PHN). Methods: This retrospective single-center study included consecutive adults who underwent thoracic interlaminar epidural steroid injection between January 2022 and December 2025. Pain intensity was assessed using the Numeric Rating Scale (NRS) at baseline and at 1 and 6 months. Global Perceived Effect (GPE), ≥30% and ≥50% NRS responder rates, repeat injections, and documented adverse events were evaluated. Limited missing follow-up information was completed by telephone in five patients under the ethics-approved protocol. Changes in NRS were analyzed using the Friedman test with Bonferroni-adjusted Wilcoxon signed-rank comparisons. Results: Forty-one patients were included; PHN was the predominant etiology (24/41, 58.5%). Median NRS decreased from 7.0 (IQR, 1.0; range, 6-9) at baseline to 3.0 (IQR, 4.0; range, 0-8) at 1 month and 1.0 (IQR, 3.5; range, 0-7) at 6 months (overall p<0.001). At 6 months, 34 patients (82.9%; 95% CI, 68.7%-91.5%) achieved ≥30% NRS reduction and 33 (80.5%; 95% CI, 66.0% 89.8%) achieved ≥50% reduction. GPE scores of 6-7 were reported by 22 patients (53.7%; 95% CI, 38.7%-67.9%). Ten patients (24.4%) received a second injection between months 1 and 3. Three transient adverse events (7.3%) were documented (two cases of local pain and one transient blood-pressure elevation), with no serious adverse events. In descriptive subgroup analyses, 20/24 patients (83.3%) with PHN and 13/17 (76.5%) without PHN achieved at least 50% NRS reduction at 6 months. Conclusion: Thoracic interlaminar epidural steroid injection was associated with clinically meaningful improvement during 6-month follow-up in this PHN-predominant real-world cohort. Because the study was retrospective and uncontrolled and repeat injections occurred in one-quarter of patients, the findings describe outcomes associated with the treatment strategy rather than causal efficacy of a single injection. Prospective controlled studies are warranted.