Introduction Lumbar and leg pain can be caused by many factors, including scar tissue in the epidural space. Epidural fibrosis may cause chronic radicular low back pain. Adhesions in the epidural space may occur due to surgical or non-surgical reasons. Epidural adhesiolysis, i.e., neuroplasty, eliminates the pain-causing effects of scar tissue by releasing the nerve from the scar tissue or decompressing the nerve. In light of this information, this study was conducted to evaluate the effectiveness of percutaneous epidural neuroplasty interventions performed in the algology clinic in patients with lumbar epidural fibrosis who have and have not undergone lumbar surgery. Methods The sample of this retrospective study consisted of 72 patients with chronic radicular low back pain, finding fibrosis in the epidural region on contrast-enhanced magnetic resonance imaging (MRI), filling defect after epidurogram, and caudal epidural neuroplasty. Patients' visual analog scale (VAS) and Oswestry disability index (ODI) scores, pregabalin, duloxetine, and opioid doses were evaluated before and one month and six months after having neuroplasty. Results The VAS and ODI scores and pregabalin, duloxetine, and opioid doses decreased significantly in patients who had had caudal epidural neuroplasty at post-procedure endpoints compared to before the procedure (p<0.001). The paired temporal comparisons of the data of the patients who underwent epidural neuroplasty procedures before the procedure, one month after the procedure, and six months after the procedure revealed significant differences in the VAS and ODI scores (p<0.001). Additionally, the analysis of patients' VAS scores revealed that the pre-procedure VAS scores decreased significantly more one month after the procedure in patients without a history of lumbar surgery than in patients with a history of lumbar surgery. Conclusions The findings of our study demonstrated that fluoroscopy-guided percutaneous epidural neuroplasty alleviated pain and improved physical functions and quality of life. In conclusion, percutaneous epidural neuroplasty is a safe and effective treatment method for patients with lumbar epidural fibrosis.

Objectives: This study aimed to examine whether there is an association between hip osteoarthritis and vitamin D receptor gene FokI polymorphisms. Patients and methods: In this case-control study, a total of 162 volunteers (43 males, 119 females; mean age: 62.4±9.3; range, 50 to 80 years) were included between March 2011 and March 2012. The patient group included 80 individuals with a diagnosis of coxarthrosis. Eightytwo individuals with normal hip, low back, and sacroiliac joint examination were included in the control group. The American College of Rheumatology hip osteoarthritis classification criteria were used in the diagnosis of coxarthrosis. Analysis of FokI polymorphisms was performed with restriction fragment length polymorphisms. Results: When the genotype and allele distributions of vitamin D receptor FokI polymorphisms were examined, no statistical difference was found in both groups. Conclusion: No significant association between the hip osteoarthritis and FokI polymorphisms could be obtained.

Osteoarthritis (OA) is a condition with high prevalence worldwide. OA affects not only the articular cartilage, but the entire joint, including the subchondral bone, ligaments, capsule, synovial membrane and the periarticular muscles. Despite the fact that the risks associated with OA increase with age, it is not a part of the natural aging process. It typically involves the knee, hip, spine, hand and foot joints. Several factors play an important role in the pathogenesis of OA, including biomechanical factors, proinflammatory mediators and proteases. On the other hand, it was mostly the results of the studies conducted on the genetic, genomic and epigenetic aspects of OA, from among many of its underlying etiological factors, which shed light on the molecular processes involved in the etiopathogenesis of OA. As the mechanisms that cause joint tissue damage in OA come to light, the treatment of OA will go beyond just providing symptomatic relief. Consequentially, new treatments will emerge that will either slow or completely stop the progression of OA.

Aim: This study was carried out to investigate the effect of conventional physiotherapy (CPT) and median nerve radiofrequency therapy (MNRFT) on kinesiophobia in patients with lumbar facet syndrome (LFS). Methods: The sample of this study consisted of 60 patients over 18 with facet joint pain persisting for at least 3 months and unresponsive to medical treatment were included in the study. The patients were divided into CPT and MNRFT groups of 30 patients each according to the treatment they received. The patients were evaluated for pain severity, kinesiophobia, sleep quality, functional status, and depression both before the treatment and one month after the treatment using the Visual Analogue Scale (VAS), Tampa Scale for Kinesiophobia (TKS), Pittsburgh Sleep Quality Index (PSQI), Oswestry Disability Index (ODI) and Beck’s Depression Inventory (BDI), respectively. Results: There was a significant difference between the pre- and post-treatment VAS, PSQI, ODI, and BDE scores in both the CPT and MNRFT groups. Additionally, there was a significant difference between the pre- and post-treatment TKS scores in the RFT group, but not in the CPT group. There was no significant difference between the groups in any of the pre-treatment scores. There was also no significant difference between the groups in the post-treatment scores, except for the TKS scores. Conclusion: The study findings indicated that MNRFT and median nerve blockade reduced kinesiophobia more than CPT.

Aim The objective of this study is to evaluate the outcomes of unilateral percutaneous kyphoplasty (PKP) performed in treatment-resistant patients with osteoporotic vertebral fractures. Material and Methods The study sample consisted of eight patients with painful osteoporotic compression fractures who did not respond to conservative treatment methods. However, the respective clinical results were evaluated based on radiological findings pertaining to 18 operated vertebrae of the said eight patients. The Oswestry Disability Index (ODI) scores and Visual Analogue Scale (VAS) scores were recorded before the procedure and at the 1st-month and 6th-month follow-up visits. Vertebral angle (VA), and anterior height (AH), central height (CH) and posterior height (PH) of the superior and inferior endplates of the vertebrae were measured before the procedure and at the 6th-month follow-up using direct radiography. Results Mean VAS and ODI scores decreased 66.87% and 65.13%, respectively, over a 6-month period. The mean vertebral height increased after kyphoplasty, as reflected by a 4.70% increase in AH, 26.84% increase in CH and 1.63% increase in PH. Additionally, VA was found to have increased by 14.1%. Conclusion The results of this study featuring a small patient population indicated that unilateral balloon PKP can be used safely and effectively to achieve earlier mobilization with faster pain relief and fewer complications.

Background/Objectives: Sacroiliac joint (SIJ) dysfunction is a common yet frequently underdiagnosed cause of chronic low back pain. This study aimed to compare the clinical effectiveness of ultrasound-guided corticosteroid and ozone injections in patients with chronic low back pain due to SIJ dysfunction. Methods: This comparative clinical study included 64 patients with chronic sacroiliac joint (SIJ) dysfunction who received ultrasound-guided SIJ injections with either corticosteroid (n = 31) or ozone (n = 33). Participants had a mean age of 45.0 ± 7.7 years, and the sex distribution was 42/22 (female/male). Pain intensity was assessed using the Numeric Rating Scale (NRS), disability using the Oswestry Disability Index (ODI), and quality of life using the Short Form-12 Physical (PCS) and Mental (MCS) Component Summary scores. Outcomes were evaluated at baseline, 3 months, and 6 months. Longitudinal changes were analyzed using two-way repeated-measures ANOVA (group × time) with Bonferroni-adjusted post hoc comparisons. Effect sizes were calculated using Cohen’s d. Normality and homoscedasticity were assessed (Shapiro–Wilk and Levene tests), and baseline comparisons were performed using appropriate parametric or non-parametric tests. Results: Both treatments significantly improved pain, disability, and quality of life at 3 months (p < 0.01). However, improvements were significantly greater and more durable in the ozone group across all outcomes at both 3 and 6 months (p < 0.01). At 6 months, between-group differences favored ozone for NRS (mean difference −2.81; Cohen’s d = −2.36), ODI (−6.05; d = −1.46), SF-12 PCS (+4.24; d = 1.24), and SF-12 MCS (+4.22; d = 0.83). A ≥50% pain reduction was achieved at 3 months in 97.0% of ozone-treated patients versus 45.2% of corticosteroid-treated patients (p < 0.01) and persisted at 6 months in 18.2% and 0% of patients, respectively (p < 0.05). The magnitude of improvement in the ozone group exceeded commonly reported Minimal Clinically Important Difference (MCID) thresholds for chronic low back pain outcomes, supporting clinical relevance. Conclusions: Ultrasound-guided ozone injection provided greater and more durable improvements in pain relief, functional status, and quality of life compared with corticosteroid injection in patients with SIJ dysfunction.