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A prospective study in management of lumbar radiculopathy patients with selective nerve root block
*Corresponding Author: Dr. Pradeep E Email: dr_prad87@yahoo.co.in
Abstract
Background:
Prolapsed Intervertebral Disc (PID) was considered to be the commonest cause of sciatica among many others. Though the presentation of sciatica was paradoxical, in which, some people experienced sciatica without any disc prolapse on MRI/CT, whereas some people showed a prolapsed disc without experiencing any of the symptoms related to sciatica. This gave rise to different explanations that a disc prolapse in itself , is not enough to cause sciatica, and there might be some local chemical agents that might be the causative factor due to their insulting attitude on the nerve roots.
Objectives:
To study the functional outcome of patients with Posterior Lumbar Intervertebral disc prolapse (PLIVDP), Lumbar Canal Stenosis, and Lumbar radiculopathy after Selective Nerve Root Block at the corresponding level.
Materials and Methods:
A prospective cohort study on the functional outcome of patients with lumbar radiculopathy with Intervertebral disc prolapse or lumbar canal stenosis. Outcome measures used in this study are Owestry disability index score and Numerical rating scale. All patients had taken an MRI scan, which was classified according to the Michigan state university classification. After initial check up, pre-anaesthetic check up, selected patients were given Selective Nerve Root Block with Methyl Prednisolone and local anaesthetic Bupivacaine. Patients were scored at Immediate post Op, 3 weeks and 3 months after the injection was given and the data was collected.
Results:
A total of 127 patients were given Selective Nerve Root Block in the study period. Patients that were aged from 20-80 years were included. Average pre-injection ODI scores (in percent) were 75.24, at 1 month 20.52 and at 4 months 19.86, with a p value of <0.001. Mean NRS ratings pre injection were 8.73, Immediate post op were 1.89, at 4 weeks it was 1.48 and 4 months 1.27. Mean SLR (in degrees) Pre Injection was 48.3, Immediate was 80.00, at 4 weeks was 80.2 and at 4 months was 80.5.
Conclusion:
Selective Nerve Root Block is a good therapeutic procedure for pain management in the patients with Lumbar radiculopathy, and it can be used as a standard procedure, before advising the patient for any form of surgery
