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Back Pain: HELP
Articles by Osman Hakan Gunduz
Based on 6 articles published since 2008
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Between 2008 and 2019, O. H. Gunduz wrote the following 6 articles about Back Pain.
 
+ Citations + Abstracts
1 Article Does facet tropism negatively affect the response to transforaminal epidural steroid injections? A prospective clinical study. 2019

Celenlıoglu, Alp Eren / Sencan, Savas / Gunduz, Osman Hakan. ·Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Faculty of Medicine, Erciyes University, 38030, Kayseri, Turkey. a.celenlioglu@gmail.com. · Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Faculty of Medicine, Marmara University, Mimar Sinan Caddesi No:41 Üst Kaynarca Fevzi Çakmak Mahallesi Pendik, 34906, Istanbul, Turkey. ·Skeletal Radiol · Pubmed #30603772.

ABSTRACT: OBJECTIVE: To examine the impact of the presence of facet tropism on the results of transforaminal epidural steroid injection for unilateral radicular pain induced by lumbar disc herniation. MATERIALS AND METHODS: We included 112 patients diagnosed with unilateral, single-level lumbar disc herniation-induced radicular pain. Injection was planned at relevant levels. The patients were assessed using the Numerical Rating Scale, the Modified Oswestry Disability Index, and the Beck Depression Inventory before the injection and at hour 1, week 3, and month 3 after the injection. Presence of facet tropism was assessed by measuring the facet angles in the L3-4, L4-5, and L5-S1 segments of lumbar MRI T2 sequence axial section. RESULTS: A significant decrease in the Numerical Rating Scale and an increase in the Modified Oswestry Disability Index scores were detected at all follow-ups in groups comprising 39 patients with and 61 without facet tropism (p < 0.05). On comparison, improvement in clinical parameters at week 3 and month 3 in the group without facet tropism was greater (p < 0.05). As treatment success is considered to be a ≥ 50% reduction in the Numerical Rating Scale scores, 55.2% of the patients attained treatment success at month 3. Further, although the treatment success rate in the group with facet tropism was 34.2%, it was 69% in that without facet tropism (p < 0.05). CONCLUSION: Facet tropism correlates with less success of transforaminal epidural steroid injection; therefore, facet tropism may be a worthwhile measurement in a discussion with patients of the benefits of the procedure.

2 Article The influence of coccygeal dynamic patterns on ganglion impar block treatment results in chronic coccygodynia. 2018

Sencan, Savas / Cuce, Isa / Karabiyik, Ozgur / Demir, Fatmagul U / Ercalik, Tulay / Gunduz, Osman H. ·1 Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey. · 2 Department of Physical Medicine and Rehabilitation, Adiyaman University Training and Research Hospital, Adiyaman, Turkey. · 3 Department of Radiology, Kayseri Training and Research Hospital, Kayseri, Turkey. · 4 Department of Physical Medicine and Rehabilitation, Kayseri Training and Research Hospital, Kayseri, Turkey. · 5 Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey. · 6 Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Faculty of Medicine, Marmara University, Istanbul, Turkey. ·Interv Neuroradiol · Pubmed #29969959.

ABSTRACT: Objective Ganglion impar block (GIB) can be performed in patients with chronic coccygodynia who do not respond to conservative treatments. We investigated the effect of coccygeal dynamic patterns on the treatment outcome in patients with chronic coccygodynia treated with GIB. Materials and methods We retrospectively analyzed the data for patients diagnosed with chronic coccygodynia who underwent GIB only once by a transsacrococcygeal method under fluoroscopy guidance in our Pain Medicine Clinic. Patients were assessed with standard and dynamic coccyx radiographs and classified according to coccygeal mobility. Pain scores were assessed with a numerical rating scale (NRS) before and after the intervention (at 1 hour and 4, 12 and 24 weeks). A 50% or more reduction in the NRS score was accepted as significant pain relief. Results Of the 37 patients included in the study, 14 had normal coccyx (Group I) and 23 had immobile coccyx (Group II) based on the radiological evaluation. The NRS scores were significantly reduced in both groups on each follow-up visit but there was no significant difference between the two groups in terms of pre- and post-intervention NRS scores. Significant pain relief was achieved in 42.9% and 61.9% of patients in Group I and II at the last examination, respectively. Conclusion GIB administered by transsacrococcygeal method in patients with chronic coccygodynia is a safe and alternative treatment approach with reduced pain scores and low complication rates. In patients with chronic coccygodynia, having a normal or immobile coccyx does not appear to affect treatment outcomes.

3 Article Value of Examination Under Fluoroscopy for the Assessment of Sacroiliac Joint Dysfunction. 2015

Eskander, Jonathan P / Ripoll, Juan G / Calixto, Frank / Beakley, Burton D / Baker, Jeffrey T / Healy, Patrick J / Gunduz, O H / Shi, Lizheng / Clodfelter, Jamie A / Liu, Jinan / Kaye, Alan D / Sharma, Sanjay. ·Department of Anesthesiology, Tulane School of Medicine, New Orleans, LA. · Department of Anesthesiology, Southeast Louisiana Veterans Health Care System, New Orleans, LA; · PM&R, Southeast Louisiana Veterans Health Care System, New Orleans, LA. · Research(WOC), Southeast Louisiana Veterans Health Care System, New Orleans, LA. · PM&R, Southeast Louisiana Veterans Health Care System, New Orleans, LA; · Department of Anesthesiology, Southeast Louisiana Veterans Health Care System, New Orleans, LA. ·Pain Physician · Pubmed #26431131.

ABSTRACT: BACKGROUND: Pain emanating from the sacroiliac (SI) joint can have variable radiation patterns. Single physical examination tests for SI joint pain are inconsistent with multiple tests increasing both sensitivity and specificity. OBJECTIVE: To evaluate the use of fluoroscopy in the diagnosis of SI joint pain. STUDY DESIGN: Prospective double blind comparison study. SETTING: Pain clinic and radiology setting in urban Veterans Administration (VA) in New Orleans, Louisiana. METHODS: Twenty-two adult men, patients at a southeastern United States VA interventional pain clinic, presented with unilateral low back pain of more than 2 months' duration. Patients with previous back surgery were excluded from the study. Each patient was given a Gapping test, Patrick (FABERE) test, and Gaenslen test. A second blinded physician placed each patient prone under fluoroscopic guidance, asking each patient to point to the most painful area. Pain was provoked by applying pressure with the heel of the palm in that area to determine the point of maximum tenderness. The area was marked with a radio-opaque object and was placed on the mark with a fluoroscopic imgage. A site within 1 cm of the SI joint was considered as a positive test. This was followed by a diagnostic injection under fluoroscopy with 1 mL 2% lidocaine. A positive result was considered as more than 2 hours of greater than 75% reduction in pain. Then, in 2-3 days this was followed by a therapeutic injection under fluoroscopy with 1 mL 0.5% bupivacaine and 40 mg methylprednisolone. RESULTS: Each patient was reassessed after 6 weeks. The sensitivity and specificity in addition to the positive and negative predictive values were determined for both the conventional examinations, as well as the examination under fluoroscopy. Finally, a receiver operating characteristic (ROC) curve was constructed to evaluate test performance. The sensitivity and specificity of the fluoroscopic examination were 0.82 and 0.80 respectively; Positive predictive value and negative predictive value were 0.93 and 0.57 respectively. The area under ROC curve was 0.812 which is considered a "good" test; however the area under ROC for the conventional examination were between 0.52-0.58 which is considered "poor to fail". LIMITATIONS: Variation in anatomy of the SI joint, small sample size. CONCLUSIONS: Multiple structures of the SI joint complex can result in clinical symptoms of pain. These include intra-articular structures (degenerative arthritis, and inflammatory conditions) as well as extra-articular structures (ligaments, muscles, etc.).

4 Article Pain Relief due to Transsacrococcygeal Ganglion Impar Block in Chronic Coccygodynia: A Pilot Study. 2015

Gunduz, Osman Hakan / Sencan, Savas / Kenis-Coskun, Ozge. ·Marmara University School of Medicine, Department of Physical Medicine and Rehabilitation, Section of Pain Medicine, Istanbul, Turkey. · Pain Medicine Fellow, Marmara University School of Medicine, Department of Physical Medicine and Rehabilitation, Section of Pain Medicine, Istanbul, Turkey. · Physical Medicine and Rehabilitation Resident, Marmara University School of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey. ·Pain Med · Pubmed #25801345.

ABSTRACT: OBJECTIVE: Coccygodynia is a distressing condition that presents with pain around the coccyx. Impar (Walther) ganglion is a sympathetic ganglion located at the end of lumbosacral sympathetic chain. The objective of this study is to share our results and follow up of 34 ganglion impar blocks in 22 patients. DESIGN: Retrospective pilot study. SETTING: Interventional Pain Clinic in the Department of Physical Medicine and Rehabilitation in a university hospital. SUBJECTS: Twenty-two patients with coccygodynia who did not respond to conservative treatment and then presented to interventional pain clinic of a PM&R department in a university hospital METHODS: Pain was evaluated via 10-cm visual analog scale (VAS). VAS values were obtained before, 1 hour and 3 weeks after injection and during this study was conducted. RESULTS: For achieving at least 50% relief of pain, the success rate of a first injection was 82%, but accounted for three technical failures. In patients with a successful outcome, relief lasted for a median duration of 6 months. Relief was reinstated for a median period of 17 months by a second injection in nine patients who presented for repeat treatment. No relief was achieved in two of these patients when they presented for a third treatment. CONCLUSIONS: Ganglion impar block appears to be effective in patients who have coccygodynia resistant to conservative therapy, with high success rates and prolonged duration of effect. Controlled studies are required to reveal the mechanism of this effect.

5 Article Ankylosing spondylitis and a diagnostic dilemma: coccydynia. 2014

Deniz, R / Ozen, G / Yilmaz-Oner, S / Aydin, S Z / Erzik, C / Gunduz, O H / Inanc, N / Direskeneli, H / Atagunduz, P. ·Marmara University, Faculty of Medicine, Istanbul, Turkey. r.deniz@outlook.com. ·Clin Exp Rheumatol · Pubmed #24480355.

ABSTRACT: OBJECTIVES: Coccydynia is defined as pain in or around the tail bone area. The most common cause of coccydynia is either a trauma such as a fall directly on to the coccyx or repetitive minor trauma. The etiology remains obscure in up to 30% of patients. The literature on the contribution of rheumatic diseases to coccydynia is scarce. Our objective was to investigate the prevalence of coccydynia in ankylosing spondylitis (AS) patients. METHODS: One hundred and seven consecutive patients with AS were evaluated for coccydynia were enrolled between January and November 2012 for a cross-sectional analysis. Seventy-four consecutive patients were followed for mechanical back pain as controls and the AS patients were interviewed for the presence of coccydynia. The data collected was evaluated on SPSS® version 11.5 and Microsoft Excel® Programmes. RESULTS: Prevalence of coccydynia in AS (38.3%) was significantly higher than the control group (p<0.0001) in both female and male AS patients (female AS vs. control=40.9% vs. 18.4%, p=0.015 and male AS vs. control=36.5% vs. 8.0%, p=0.005). Both genders were affected equally in the AS group whereas coccydynia was slightly more frequent in female patients in the control group. CONCLUSIONS: Coccydynia is a previously neglected symptom of AS and it is almost three times more common in AS than in non-specific chronic low back pain. Our observation may implicate that inflammatory diseases have a role in the etiology of coccydynia, especially in those without a history of recent or past trauma and coccydynia may be a factor associated with the severity of AS as well.

6 Minor Recovery of H-Reflex with Transforaminal Epidural Steroid Injection in S1 Radiculopathy. 2017

Gunduz, Osman Hakan / Sencan, Savas / Ercalik, Tulay / Suhaimi, Anwar. ·Department of Physical Medicine and Rehabilitation, Section of Pain Medicine, Marmara University School of Medicine, Istanbul, Turkey. · Physical Medicine and Rehabilitation Clinic, Kayseri Training and Research Hospital, Kayseri, Turkey. · Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. ·Pain Med · Pubmed #28087843.

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