Anesthesiology and Reanimation Specialist Prof. Dr. Serbulent Gökhan Beyaz answered the most frequently asked questions about pain treatments. What are the diseases that cause low back and neck pain? What kind of treatments are used in the treatment of waist and neck hernias? Does every waist and neck hernia require surgery? How are Interventional Pain Treatment Methods applied?
What are the diseases that cause back and neck pain?
The pain caused by the musculoskeletal system is the most common cause of low back and neck pain. In addition, it is the pain associated with lumbar and neck hernia, which is common in the community. Hernias are anatomical structures located between the vertebrae and serve as cushions that prevent the vertebral bones from touching each other. Whatever the task of the meniscus in the knee joint, the task of these pillows between the vertebrae is the same. With the deterioration of these structures over time, pain occurs after herniation backwards. The causes that I classify as 4K are canal stenosis, slippage, calcifications and cancer. We may encounter serious back and neck pain due to the spread of cancer to the spine and other reasons.
What kind of treatments are used in the treatment of waist and neck hernias?
In fact, such treatments are very broad and diverse. It is not widely known and practiced in our country. Because if the pain due to back and neck hernia does not go away with painkillers-muscle relaxants, rest and physical therapy, patients are faced with 2 ways. The first is to live with these pains, and the second is to have surgery if the pain does not go away. I wish the pain was completely relieved after the operation. But mostly this is not the case and our patients continue to feel pain after open surgery. So-called interventional pain treatments are not just pain relief, but many can also cure the disease. These applications include epidural injection, nerve root injections, treatment of hernias with radiofrequency and laser, ozone gas injection into the hernia (especially very effective in the healing of neck hernias), reduction of hernias with epiduroscopy, morphine pump application in the treatment of cancer pain, calcifications in the neck and waist and hernias. stem cell applications.
Does every waist and neck hernia require surgery?
Of course it doesn't. Now, 99% of hernias can be treated with interventional pain treatment methods. The important thing is to find out which of the hernias in the patient cause pain. The fact that 3 hernias are seen in the MR images of the patients does not mean that all of them cause pain. For this reason, the patient should be well examined, hernias and other anatomical structures should be carefully evaluated in MR images, and the most appropriate interventional pain treatment should be selected and applied.
Can interventional pain treatments be applied in patients who have undergone operations such as platinum, plate and screw?
From our point of view, there are two types of surgery. There are patients who have undergone open surgeries such as microdiscectomy, and those whose pain persists after procedures such as plate, screw and platinum. Many pain treatments can be applied to both groups of patients, and these procedures are slightly different. Because surgeries can unfortunately lead to bad tissue formation and the incidence of this is quite high. Long-term or untreated hernias also cause an inflammatory condition called inflammation, causing poor tissue development. Cleaning these tissues around the nerves is sometimes the primary goal.
Can such treatments be applied for pain in those with heart disease, kidney failure, diabetes?
In fact, interventional pain treatments are methods that contribute to the pain-free lives of such patients. They are also very safe and effective treatments for those who cannot have surgery due to their illness, due to pain caused by herniated disc or neck hernia, calcification, or for patients who do not want to have surgery because of the risks of open surgery.
How are Interventional Pain Treatment Methods applied?
These treatments must be performed with the help of C-arm fluoroscopy and ultrasonography, which we call imaging methods. Because it is very important to instantly see where the needle you place in the body is, to deliver the needle to the right place and to apply the right dose. The effectiveness and usefulness of operations that are not implemented with imaging methods are always questioned. Sometimes it can even be considered as no action.
When can patients travel after the operation?
We want patients who come to the hospital on the day of the operation to be hungry. Patients are taken to the operating room after the previous blood tests are normal. It takes 15-20 minutes on average, depending on the procedure. 1 hour after the procedure, the patient eats and is discharged after being checked. We recommend our patients coming from outside the city to travel with a corset if the waist region has been treated. It would be appropriate not to drive on the first day.