KRONİK TOPUK AĞRISI OLAN HASTALARA ULTRASONOGRAFİ EŞLİĞİNDE UYGULANAN POSTERİOR TİBİAL VE SURAL SİNİR PULSED RADYOFREKANS İŞLEMİNİN ETKİNLİĞİ

Year 2021, Volume: 28 Issue: 4, 559 - 563, 30.12.2021

Fahrettin Kırçiçek Miraç Alasu , Pakize Kırdemir

https://doi.org/10.17343/sdutfd.970569

Abstract

Amaç
Bu çalışmanın amacı kronik topuk ağrısı olan hastalara
ultrasonografi (USG) eşliğinde uygulanan posterior
tibial ve sural sinir pulsed radyofrekans (PRF) işleminin
ağrı skoruna ve günlük aktiviteye etkisini değerlendirmek
Gereç ve Yöntem
Kronik topuk ağrısı olan ve USG ile posterior tibial ve
sural sinir PRF işlemi uygulanmış 21 hastanın verileri
tarandı. Ağrı değerlendirmesi için sayısal değerlendirme
ölçeği (NRS) ve fonksiyonel kapasite için Amerikan
Ortopedik Ayak-Ayak Bileği Derneği (AOFAS)
skoru kullanıldı. İşlemden önceki değerler ile işlemden
sonraki 1., 3., 6. aylardaki değerler karşılaştırıldı.
Bulgular
Çalışmaya dahil edilen hastaların demografik verilerine
bakıldığında yaş ortalamaları 51,80±10,87’di. 15
kadın 6 erkek olmak üzere toplam 21 hasta çalışmaya
dahil edildi. Hastaların posterior tibial ve sural sinir
PRF işlemi öncesi NRS değerleri ortalama 8,47±0,60,
AOFAS ortalama değerleri 46,71±5,28’di. Hastaların
posterior tibial ve sural sinir PRF işlemi sonrası 1., 3.,
6. aylardaki NRS ve AOFAS değerleri, işlem öncesi
NRS ve AOFAS değerleri ile kıyaslandığında istatistiksel
olarak anlamlı düşük bulundu.
Sonuç
Kronik topuk ağrısı olan hastalara USG eşliğinde
uygulanan posterior tibial sinir ve sural sinir PRF işleminin
6 aylık periyotta hem ağrıya hem de günlük
aktiviteler üzerine olumlu etkisi olduğunu gözlemledik.

Keywords

topuk ağrısı, pulsed radyofrekans, posterior tibial sinir, sural sinir

EFFICIENCY OF ULTRASOUND GUIDED PULSED RADIOFREQUENCY OF POSTERIOR TIBIAL AND SURAL NERVE IN PATIENTS WITH CHRONIC HEEL PAIN

Abstract

Objective
The aim of this study is to evaluate the effect of
ultrasonography (USG) guided posterior tibial and
sural nerve pulsed radiofrequency (PRF) treatment
on pain score and daily activity in patients with chronic
heel pain.
Materials and Methods
The data of 21 patients with chronic heel pain who
underwent posterior tibial and sural nerve pulsed
rf with USG were scanned. Numerical rating scale
(NRS) was used for pain assessment and American
Orthopedic Foot-Ankle Association (AOFAS) score
was used for functional capacity. The values before
the procedure and the 1, 3, 6 months after the
procedure were compared.
Results
The demographic data of the patients included in
the study, the mean age was 51.80±10.87 years. A
total of 21 patients, 15 females and 6 males, were
included in the study. The NRS and AOFAS values
of the patients 1, 3, 6 months after the posterior tibial
and sural nerve PRF procedure were found to be
statistically significantly lower when compared to the
pre-procedural NRS and AOFAS values.
Conclusion
We observed that the USG guided posterior tibial
nerve and sural nerve PRF treatment in patients with
chronic heel pain were positive effect on both pain
and daily activities in a 6-month period.

Keywords

heel pain, pulsed radiofrequency, posterior tibial nerve, sural nerve

References

• 1. Orhurhu V, Urits I, Orman S, Viswanath O, Abd-Elsayed A. A Systematic Review of Radiofrequency Treatment of the Ankle for the Management of Chronic Foot and Ankle Pain. Curr Pain Headache Rep. 2019; 19;23(1):4.
• 2. Khan SH, Thevarajah V, Zubairy AI. Imaging the patient with heel pain. Br J Hosp Med (Lond). 2019; 2;80(4):192-5.
• 3. Aşansu MA, Yıldırım Y. Topuk ağrısı. TOTBİD Dergisi 2013; 12:447–454.
• 4. Uysal B, Beyzadeoglu M, Sager O, Demiral S, Gamsız H, Dincoglan F, et al. Role of radiotherapy in the management of heel spur. Eur J Orthop Surg Traumatol. 2015;25(2):387-9.
• 5. Sır E, Eksert S. The use of intralesional and posterior tibial nerve pulsed radiofrequency in the treatment of calcaneal spur. Gulhane Med J 2019;61:162-166.
• 6. Napoli A, Alfieri G, Scipione R, Andrani F, Leonardi A, Catalano C. Pulsed radiofrequency for low-back pain and sciatica. Expert Rev Med Devices. 2020;17(2):83-86.
• 7. Trescot, AM. Peripheral Nerve Entrapments: Clinical Diagnosis and Management. 1.ed.2016.
• 8. Counsel PD, Davenport M, Brown A, Ooi CC, Comin J, Marks P, et al. Ultrasound-Guided Radiofrequency Denervation of the Medial Calcaneal Nerve. Clin J Sport Med. 2016;26(6):465- 470.
• 9. Cione JA, Cozzarelli J, Mullin CJ. A retrospective study of radiofrequency thermal lesioning for the treatment of neuritis of the medial calcaneal nerve and its terminal branches in chronic heel pain. J Foot Ankle Surg 2009;48:142-147.
• 10. Karaman H, Tufek A, Kavak GO, Yildirim ZB, Celik F. Would pulsed radiofrequency applied to different anatomical regions have effective results for chronic pain treatment J Pak Med Assoc 2011;61:879-885.
• 11. Gomes Tarroso M.J, Faria J, Azevedo C, Lages N, Correia C. Ultrasound-guided sural nerve pulsed radiofrequency for the treatment of ankle neuropathic pain, European Journal of Anaesthesiology: June 2014;31:219.
• 12. Osman AM, El-Hammady DH, Kotb MM. Pulsed Compared to Thermal Radiofrequency to the Medial Calcaneal Nerve for Management of Chronic Refractory Plantar Fasciitis: A Prospective Comparative Study. Pain Physician. 2016;19(8): 1181-87.
• 13. Higuchi Y, Nashold BS, Jr., Sluijter M, Cosman E, Pearlstein RD. Exposure of the dorsal root ganglion in rats to pulsed radiofrequency currents activates dorsal horn lamina I and II neurons. Neurosurgery. 2002;50: 850-855.
• 14. Hamann W, Abou-Sherif S, Thompson S, Hall S. Pulsed radiofrequency applied to dorsal root ganglia causes a selective increase in ATF3 in small neurons. Eur J Pain. 2006;10:171-176.
• 15. Arslan A, Koca TT, Utkan A, Sevimli R, Akel İ. Treatment of Chronic Plantar Heel Pain With Radiofrequency Neural Ablation of the First Branch of the Lateral Plantar Nerve and Medial Calcaneal Nerve Branches. J Foot Ankle Surg. 2016;55(4):767-771.
• 16. Wu YT, Chang CY, Chou YC, Yeh CC, Li TY, Chu HY, Chen LC. Ultrasound-Guided Pulsed Radiofrequency Stimulation of Posterior Tibial Nerve: A Potential Novel Intervention for Recalcitrant Plantar Fasciitis. Arch Phys Med Rehabil. 2017;98(5): 964-970.
• 17. Kim KH, Yoo JY, You BC. Ultrasonographic evaluation of sural nerve for nerve conduction study. Ann Rehabil Med 2014;38:46–51.
• 18. Todorov L. Pulsed radiofrequency of the sural nerve for the treatment of chronic ankle pain. Pain Physician. 2011;14(3): 301-4.
• 19. Salinas FV. Evidence Basis for Ultrasound Guidance for Lower-Extremity Peripheral Nerve Block: Update 2016. Reg Anesth Pain Med. 2016;41(2):261-274.
• 20. Agyekum EK, Ma K. Heel pain: A systematic review. Chin J Traumatol. 2015;18(3): 164-9.