Transforaminal Selective Nerve Root Blocks for Treating Single Lumbosacral Radiculopathy: The Short-term Outcome and Efficiency

Sang-Bum Kim; Taek-Soo Jeon; Won-Ki Park; Sung-Kwun Jo; Yong-Sang Kim; Cheol-Mog Hwang

doi:10.4055/jkoa.2009.44.6.619

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Kim, Jeon, Park, Jo, Kim, and Hwang: Transforaminal Selective Nerve Root Blocks for Treating Single Lumbosacral Radiculopathy: The Short-term Outcome and Efficiency

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(6): 619-626.

Published online: 21 December 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.6.619

Transforaminal Selective Nerve Root Blocks for Treating Single Lumbosacral Radiculopathy: The Short-term Outcome and Efficiency

Sang-Bum Kim, M.D., Taek-Soo Jeon, M.D., Won-Ki Park, M.D., Sung-Kwun Jo, M.D., Yong-Sang Kim, M.D., Cheol-Mog Hwang, M.D.^*

Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Korea.

^*Department of Radiology, Konyang University College of Medicine, Daejeon, Korea.

Correspondence to Taek-Soo Jeon, M.D. Department of Orthopaedic Surgery, Konyang University College of Medicine, 685, Gasoowon-dong, Seo-gu, Daejeon 302-718, Korea. Tel: +82.42-600-6937, 9120, Fax: +82.42-545-2373, sirjeon@kyuh.co.kr

Received 10 February 2009 Accepted 26 September 2009

Abstract

Purpose

We wanted to determine the clinic usefulness of selective nerve root block for treating lumbosacral radiculopathy that's due to a herniated nucleus pulposus (HNP) or foraminal stenosis (FS) by analyzing the short-term results after the selective nerve root block (SNRB) procedure.

Materials and Methods

Sixty-five patients were investigated in our research. Sixty-five patients were divided into two groups: thirty-seven patients of group one were the HNP patients and twenty-eight patients of group two were the FS patients. The effect of SNRB treatment was assessed by the degree of radiating pain in lower legs with using the visual analogue scale (VAS) and patients' subjective satisfaction. The average overall follow-up period was eleven months: that of the first group was 13.5 months and that of the group was 7.6 months.

Results

For the 65 patients, the average VAS was 7.8 before a SNRB procedure and this decreased to 2.9 and 3.4 after one to three SNRB procedures, respectively. For group one, the VAS was 7.4 before the procedure and it decreased to 3.3 at one month and 3.7 at three months after the procedure. For group two, the VAS was 8.3 before the SNRB procedure and this favorably changed to 2.3 at one month and 3.0 at three months after the procedure. An operation was carried out due to no response for 8 patients (12%) and due to aggravation for 4 patients (6%) after the SNRB procedures. Three patients (8%) of group one and two patients (11%) of group two obtained pain relief at one month and aggravation at three months, respectively. On comparing the two groups, a better treatment effect was observed for the FS group after one month (p=0.002) and three months (p=0.01). Complications related to the SNRB procedure haaves not been observed in both groups.

Conclusion

The SNRB procedure is a very effective and safe procedure, after the appearance of symptoms, as a non-operative treatment for single lumbosacral radiculopathy due to a herniated nucleus pulposus or foraminal stenosis. This treatment appears to be more effective for the FS group than for the HNP group and it should be considered before carrying out an operative treatment.

Keywords: Lumbosacral radiculopathy, Herniated nucleus pulposus, Foraminal stenosis, Selective nerve root block, Transforaminal steroid injection

Figures and Tables

Fig. 1

(A) Anteroposterior radiograph with contrast material within the right L5 sleeve. (B) Anteroposterior radiograph with contrast material within the right S1 sleeve.

Table 1

Basic Characteristics of the Patients

Table 2

P-value of Independent t-test on the Symptom Duration and the Type of Disease

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