Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology最新文献

{"title":"Application of cervical epidural blood patch for spontaneous cerebrospinal fluid leaks: Two case reports.","authors":"Sebnem Rumeli, Mesut Bakır, Guldane Turhan, Mehmet Ertargın, Mehmet Ridvan Yalin","doi":"10.5606/agri.2026.81","DOIUrl":"https://doi.org/10.5606/agri.2026.81","url":null,"abstract":"<p><p>Spontaneous cerebrospinal fluid (CSF) leaks are uncommon but significant causes of orthostatic headaches, often resulting from dural injuries. Although lumbar epidural blood patches (EBPs) are commonly used to treat such leaks, cervical EBPs are rarely performed due to the higher risk of complications, including spinal cord injury. This case series presents two patients with spontaneous cervical CSF leaks successfully treated with cervical EBPs under fluoroscopic guidance. The first case involved a 24-year-old female who presented with a two-month history of severe orthostatic headaches and tinnitus and a Visual Analog Scale (VAS) score of 8. After a cervical EBP with 3 mL of autologous blood, her symptoms resolved. The second case describes a 55-year-old male with a history of radiotherapy who presented with a VAS score of 10 and a four-month history of orthostatic headaches. A cervical EBP using a total of 6 mL of blood led to complete symptom resolution. Both cases highlight the efficacy and safety of cervical EBPs when performed with careful imaging guidance and minimal blood volumes. These findings suggest that this approach should be considered in cases of refractory cervical CSF leaks.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 4","pages":"298-301"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of escitalopram prophylaxis with pain intensity in tension-type headache: A retrospective, comparative cohort study.","authors":"Ahmet Burak Elbeyli, Ali Zeynal Abidin Tak","doi":"10.5606/agri.2026.170","DOIUrl":"https://doi.org/10.5606/agri.2026.170","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the association between escitalopram prophylaxis and pain intensity in patients with tension-type headache.</p><p><strong>Patients and methods: </strong>This retrospective, comparative cohort study included a total of 503 patients between July 1st, 2022 and October 1st, 2022. The patients were divided into two groups according to their treatment approach. The first group (Group 1, n = 300) consisted of patients who initiated escitalopram prophylaxis. The second group (Group 2, n = 203) consisted of patients who did not receive prophylactic treatment and were monitored with symptomatic treatment. Pain intensity was assessed using the Visual Analog Scale (VAS) at baseline and after approximately three months. Between-group changes were compared, and follow-up VAS scores were evaluated using regression models adjusted for baseline VAS, age and sex. The Headache Screening Questionnaire (HSQ) findings were considered exploratory.</p><p><strong>Results: </strong>Of a total of 503 patients, 159 were male and 344 were female with a mean age of 33.00 ± 3.44 (range, 22 to 46) years. The groups were similar in age and sex distribution, although baseline VAS scores were higher in the escitalopram group. The mean VAS scores decreased from 5.06 ± 1.23 to 4.55 ± 1.17 in the escitalopram group and increased from 4.68 ± 1.40 to 4.92 ± 1.41 in the symptomatic treatment group. The difference in change between groups was significant. Escitalopram use remained associated with lower follow-up VAS scores after adjustment for baseline VAS, age and sex. The HSQ findings were exploratory and were not interpreted as confirmatory evidence of treatment efficacy.</p><p><strong>Conclusion: </strong>Escitalopram prophylaxis was associated with lower pain intensity after approximately three months. As treatment allocation was non-randomized and baseline pain severity differed between groups, the findings should be interpreted cautiously. Escitalopram warrants further investigation in patients who cannot tolerate or are unsuitable for first-line prophylactic treatments.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 4","pages":"264-271"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of clinical and procedural outcomes of transforaminal versus parasagittal interlaminar epidural steroid injections for radicular pain secondary to lumbar disc herniation.","authors":"Salim Taner Gözükızıl, Halil İbrahim Altun","doi":"10.5606/agri.2026.96","DOIUrl":"https://doi.org/10.5606/agri.2026.96","url":null,"abstract":"<p><strong>Background: </strong>This study aims to compare the clinical and procedural outcomes of transforaminal epidural steroid injections (TFESIs) and parasagittal interlaminar epidural steroid injections (P-ILESIs) in patients with unilateral radicular pain secondary to lumbar disc herniation (LDH).</p><p><strong>Patients and methods: </strong>Between January 2024 and June 2025, a total of 162 patients with unilateral radicular pain caused by single-level LDH were included in this retrospective, observational cohort study. The patients were divided into the two groups based on the technique as the TFESI group (n = 82) and the P-ILESI group (n = 80). Pain, disability, sleep quality, and health-related quality of life were assessed using the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), Pittsburgh Sleep Quality Index (PSQI), and Short Form-12 (SF-12), respectively at baseline, one month, and six months. Fluoroscopy time and cumulative radiation dose were also recorded.</p><p><strong>Results: </strong>Of the patients, 120 were male and 42 were female with a median age of 47 (range 22 to 65) years. Both techniques significantly improved pain, disability, sleep quality, and quality of life at one and six months (p < 0.001). The reduction in NRS from baseline was greater with TFESI at one month (p = 0.008), but not at six months (p = 0.545). The ODI scores were lower with TFESI at one month, although the magnitude of improvement from baseline did not significantly differ and no difference was observed at six months. Quality of life outcomes were comparable between the groups. The P-ILESI required longer fluoroscopy time and higher radiation exposure than TFESI (p < 0.001 for both). No major complications occurred, and minor adverse events were infrequent and comparable between the groups (p = 0.764).</p><p><strong>Conclusion: </strong>Both TFESI and P-ILESI appear to be effective and safe approaches for the treatment of radicular pain associated with LDH. The choice of epidural approach should be individualized according to clinical and anatomical considerations, as well as operator experience.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 4","pages":"237-246"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic complex regional pain syndrome type 1: Risk factors and the potential clinical relevance of magnesium depletion score.","authors":"Dilara Ekici Zincirci, Berkin Özer, Sevgi Atar, Esma Demirhan, Mehmet Zincirci, İlhan Karacan, Ömer Kuru","doi":"10.5606/agri.2026.103","DOIUrl":"https://doi.org/10.5606/agri.2026.103","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate whether the magnesium depletion score (MDS), an indicator of magnesium deficiency, is associated with the development of complex regional pain syndrome type 1 (CRPS-1) in patients with traumatic extremity injuries.</p><p><strong>Patients and methods: </strong>Between November 2024 and May 2025, a total of 117 patients who suffered from traumatic extremity injuries were included. Demographic and clinical data of the patients were collected and recorded, and the MDS was calculated. Age, sex, body mass index (BMI), smoking status, alcohol consumption, diabetes, hypertension, duration of immobilization, MDS, and injury-related characteristics were evaluated as potential risk factors for CRPS-1 development.</p><p><strong>Results: </strong>Of the patients, 40 were male and 77 were female with a mean age of 51.9 ± 15.01 (range, 20 to 91 years). In a total of 42.7% of patients with traumatic extremity injuries, CRPS-1 developed. The female-to-male ratio was higher among patients with CRPS-1 than among those without. The MDS, hypertension, diabetes, smoking, and alcohol consumption were not found to be independent risk factors. However, prolonged immobilization (more than one month) was found to be an independent risk factor for the development of CRPS-1.</p><p><strong>Conclusion: </strong>Our study results suggest that the MDS score is not a risk factor for developing CRPS-1, but immobilization for more than one month significantly increases the risk. Taken together, these findings indicate that the duration of immobilization following injury may be a more decisive factor in the development of CRPS-1 than demographic and clinical characteristics.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 3","pages":"166-172"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment to the article: Percutaneous pulsed radiofrequency ablation of articular nerves of the hip joint in patients with chronic hip pain refractory to conventional analgesics.","authors":"Rekib Saçaklıdır","doi":"10.5606/agri.2026.1","DOIUrl":"https://doi.org/10.5606/agri.2026.1","url":null,"abstract":"","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 3","pages":"210-211"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between tobacco use and central sensitization: A cross-sectional study.","authors":"Zehra Can Karahan, Parnian Mohammadrezaei, Asma Rahmani Tangroudi, Hatice Bernis Şahin, Mahtab Rahimikia, Sana Pourassad, Zahrasadat Naghdeh Forooshha, Naime Uluğ, Nilay Şahan","doi":"10.5606/agri.2026.87","DOIUrl":"https://doi.org/10.5606/agri.2026.87","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate the association between tobacco use and central sensitization (CS), as measured by the Central Sensitization Inventory (CSI), and to identify demographic and clinical factors associated with CS.</p><p><strong>Patients and methods: </strong>In this cross-sectional study, a total of 380 adults were included using a convenience sampling method between December 2024 and January 2025. Data collection was performed through an online survey platform to ensure accessibility and broad participation. The survey was distributed via digital platforms, social media networks, and email lists to reach a diverse adult population across Türkiye. Demographic characteristics, clinical variables, and tobacco product use status were recorded. Central sensitization was assessed using the CSI. Multiple linear and logistic regression analyses were performed to identify predictors of CSI scores.</p><p><strong>Results: </strong>Of a total of 380 participants, 131 were male and 249 were female with a mean age of 41.21 ± 11.40 (range, 18 to 65) years. Tobacco users had significantly higher CSI total scores compared to non-users (p = 0.029). A higher proportion of individuals with a CSI score ≥ 40 was observed among tobacco users (p = 0.003). In the multiple linear regression model, age (β = -0.295), female sex (β = 6.255), chronic disease status (β = 4.524), chronic pain (β = 12.093), and tobacco use (β = 6.538) were independent predictors (p < 0.001). Logistic regression analysis indicated a significant association between tobacco use and the likelihood of having a CSI score ≥ 40 (odds ratio [OR] = 0.488, 95% confidence interval [CI]: 0.302-0.789).</p><p><strong>Conclusion: </strong>Tobacco use is positively associated with higher CS symptom severity. Given the cross-sectional design, these findings reflect a correlation rather than direct causality. Nevertheless, screening for smoking habits may provide valuable context during the clinical evaluation of chronic pain.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 3","pages":"181-187"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the distance between posterior capsule and popliteal artery a limitation for IPACK at the level of femoral condyles?","authors":"Sandeep Diwan, Anju Gupta, Parag Sancheti","doi":"10.5606/agri.2026.73","DOIUrl":"https://doi.org/10.5606/agri.2026.73","url":null,"abstract":"","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 3","pages":"208-209"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of ultrasound- and fluoroscopy-guided cervical medial branch pulsed radiofrequency in chronic facet joint pain: A retrospective cohort study.","authors":"Çile Aktan, Ece Yanık","doi":"10.5606/agri.2026.74","DOIUrl":"https://doi.org/10.5606/agri.2026.74","url":null,"abstract":"<p><strong>Background: </strong>This study aims to compare clinical outcomes, procedural efficiency, and safety of pulsed radiofrequency (PRF) of the cervical medial branches performed under ultrasound (US) versus fluoroscopy (FL) guidance.</p><p><strong>Patients and methods: </strong>This single-center, retrospective cohort study included a total of 177 patients between January 2023 and June 2025. The patients were allocated to FL- (n = 75) or US-guided groups (n = 102). The Numeric Rating Scale (NRS), Neck Disability Index (NDI), and monthly analgesic use were assessed at baseline, at six weeks (primary endpoint), and at three and six months. The primary outcome inter-group NRS at six weeks was analyzed using analysis of covariance adjusted for baseline NRS, age, sex, bilaterality, and number of treated levels. Secondary outcomes included NDI, analgesic use, and procedural metrics. Six-week analyses included all patients; three- and six-month analyses used available-case data (up to n = 141). Last-observation-carried-forward (LOCF) sensitivity analyses were performed.</p><p><strong>Results: </strong>Of the 177 patients included in the study, 60 were male and 117 were female with a mean age of 53.47 ± 5.46 (range, 39 to 66) years. Compared to FL, US-guided PRF was associated with shorter procedure times (8.64 ± 0.93 vs. 14.41 ± 2.24 min), fewer needle redirections (1.36 ± 0.50 vs. 3.56 ± 1.02), and fewer minor complications (11.8% vs. 30.7%) (p ≤ 0.003 for all). At six weeks, adjusted mean NRS was 4.46 in US group versus 4.56 in FL group, with no significant inter-group difference (adjusted difference 0.10; 95% confidence interval [CI]: -0.53 to 0.34). No significant differences were observed for NDI or analgesic use at any time point. Responder, longitudinal mixed-effects, and LOCF sensitivity analyses yielded concordant results.</p><p><strong>Conclusion: </strong>Our study results suggest that US- and FL-guided cervical medial branch PRF can yield similar clinical outcomes. However, US guidance provides procedural and safety advantages without compromising effectiveness.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 3","pages":"147-157"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of sedation on patient satisfaction, radiation exposure, and complications in lumbar transforaminal epidural steroid injections: A retrospective cohort study.","authors":"Halil İbrahim Altun, Salim Taner Gözükızıl, Fatma Ayşen Eren, Gözde Altun, Ayça Sultan Şahin","doi":"10.5606/agri.2026.52","DOIUrl":"https://doi.org/10.5606/agri.2026.52","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate whether moderate sedation (MOAA/S 3-4) affects procedural efficiency, radiation exposure, patient-physician satisfaction, and clinical outcomes during lumbar transforaminal epidural steroid injections (L-TFESI).</p><p><strong>Patients and methods: </strong>Between January 2021 and January 2024, a total of 201 patients with unilateral, single-root compression who underwent L-TFESI either with (Group S, n = 99) or without sedation (Group NS, n = 102) were retrospectively analyzed. In the sedation group, midazolam and fentanyl were titrated to a target Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score of 3-4. The primary outcomes were cumulative radiation dose (mGy), fluoroscopy time, and procedural complications. Additional outcomes included Numeric Rating Scale-11 (NRS-11) scores (baseline, Day 4, Week 4) and Likert satisfaction scales.</p><p><strong>Results: </strong>Of a total of 201 patients, 143 were male and 58 were female with a mean age of 47.22 ± 10.03 (range, 22 to 65) years. Both groups were comparable in terms of baseline demographics and pain scores. The sedation group had significantly lower cumulative radiation exposure (3.92 ± 0.30 mGy vs. 4.31 ± 0.40 mGy) and shorter fluoroscopy times (28.13 ± 2.79 sec vs. 33.13 ± 3.95 sec). Minor procedural complications (commonly vasovagal reactions and hypertension) were more frequent in the non-sedated group (21.6% vs. 2.0%). Group S reported lower pain scores on Day 4 (1.11 ± 1.29 vs. 1.88 ± 1.25), although outcomes were similar at Week 4. Patient and physician satisfaction were higher in the sedation group.</p><p><strong>Conclusion: </strong>Moderate sedation (MOAA/S 3-4) during L-TFESI is associated with lower radiation exposure, shorter procedure times and fewer minor complications, while improving both patient satisfaction and procedural conditions. These findings suggest that sedation is a potentially useful adjunct in selected patients that may contribute to improved procedural quality in interventional pain management.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 3","pages":"158-165"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency thermocoagulation of the sphenopalatine ganglion in the treatment of chronic paroxysmal hemicrania.","authors":"Serdar Kokar, Ozgur Emre Polat, Yucel Olgun, Savas Sencan, Osman Hakan Gunduz","doi":"10.5606/agri.2026.76","DOIUrl":"https://doi.org/10.5606/agri.2026.76","url":null,"abstract":"","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"38 3","pages":"205-207"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}