THE INFLUENCE OF DIFFERENT MINIMALLY INVASIVE METHODS ON THE OUTCOME OF LUMBAR RADICULAR PAIN TREATMENT/UTJECAJ RAZLICITIH MINIMALNO INVAZIVNIH METODA NA ISHOD LIJECENJA LUMBALNE RADIKULARNE BOLI

Lumbar radicular pain is a major public health, social and economic problem and is often the cause of professional disability. The aim of this study was to compare pain intensity, disability and neuropatic pain depending on the method of treatment (epidural steroid injection or percutaneous laser disc decompression) in the treatment of lumbar radicular pain caused by intervertebral disc herniation with or without discoradicular contact. Data were collected from 28 patients at 3 measurement points (before the procedure and at examinations on the 15th and 30th day after the procedure) using the Numeric Rating Scale (NRS), Oswestry Disabilitiy Indeks (ODI) and Pain Detect. The reduction of the pain after the procedure was statistically significant only in the group of patients with discoradicular contact in whom PLDD was performed (P=0.04). From the obtained results, it can be concluded that percutaneous laser disc decompression (PLDD) led to a greater reduction in disability (P=0.009) in patients with discorradicular contact, whereas lumbar transforaminal epidural steroid injection (ESI TF) led to greater reduction in patients without discorradicular contact (P=0.02). The results indicate that there was a significant (P=0.01) reduction in neuropathic pain in patients without discorradicular contact who were treated with ESI TF and in patients with discoradicular contact who were treated with PLDD (P=0.04). Key words: herniated disc; epidural injection; percutaneous diskectomy; laser, lower back pain; radiculopathy Lumbalna radikularna bol je veliki javnozdravstveni, drustveni i ekonomski problem i cesto je uzrok profesionalne nesposobnosti. Cilj ovog istrazivanja bio je usporediti intenzitet boli, onesposobljenost i neuropatsku bol ovisno o nacinu lijecenja (epiduralna injekcija steroida ili perkutana laserska dekompresija diska) u lijecenju lumbalne radikularne boli uzrokovane hernijom intervertebralnog diska sa ili bez diskoradikularnog kontakta. Podaci su prikupljeni od 28 pacijenata u 3 tocke mjerenja (prije zahvata i na pregledima 15. i 30. dana nakon zahvata) pomocu Numeric Rating Scale (NRS), Oswestry Disabilitiy Indeks (ODI) i Pain Detect. Smanjenje boli nakon zahvata bilo je statisticki znacajno samo u skupini bolesnika s diskoradikularnim kontaktom kod kojih je ucinjen PLDD (p = 0,04). Iz dobivenih rezultata moze se zakljuciti da je PLDD doveo do veceg smanjenja onesposobljenosti (p = 0,009 ) u bolesnika s diskoradikularnim kontaktom a ESI u bolesn