Journal List > J Korean Orthop Assoc > v.50(2) > 1013357

Shim, Kim, Song, Kim, Kwon, and Jeon: The Usefulness of Selective Spinal Nerve Root Block in Neuropathic Pain Patients with Radiculopathy

Abstract

Purpose

This study was conducted in order to evaluate effect and efficiency of selective spinal nerve root block for neuropathic pain patients with lower leg radiating pain.

Materials and Methods

A total of 113 patients were evaluated and follow-up periods were a minimum of 12 months. They were divided into two groups: group A included 41 patients with neuropathic pain and group B included 72 patients with simple lower leg radiating pain.

Results

Fourteen (34.1%) patients in group A and 45 (62.5%) patients in group B had favorable results for selective spinal nerve block (p<0.05). Visual analog scale (VAS) was improved from 7.57 to 5.23 at 12 months in group A and from 7.11 to 3.49 at 12 months in group B.

Conclusion

The initial treatment period for group A was significantly later than in group B. For patients with neuropathic pain and radiculopathy, early assessment was recommended and early selective spinal nerve block could be a good treatment option for neuropathic pain patients.

Figures and Tables

Figure 1

Self-report of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale (S-LANSS) score in Korean.

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Table 1

Treede et al.6)'s Grading System for Neuropathic Pain

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Grading of certainty for the presence of neuropathic pain: definite neuropathic pain: all (1 to 4); probable neuropathic pain: 1 and 2, plus either 3 or 4; possible neuropathic pain: 1 and 2, without confirmatory evidence from 3 or 4. *A region corresponding to a peripheral innervation territory or to the topographic representation of a body part in the central nervous system. The suspected lesion or disease is reported to be associated with pain, including a temporal relationship typical for the condition. As part of the neurologic examination, these tests confirm the presence of negative or positive neurologic signs concordant with the distribution of pain. Clinical sensory examination may be supplemented by laboratory and objective tests to uncover subclinical abnormalities. §As part of the neurologic examination, these tests confirm the diagnosis of the suspected lesion or disease. These confirmatory tests depend on which lesion or disease is causing neuropathic pain.

Table 2

Characteristics of 113 Patients with Selective Nerve Root Block

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Values are presented as number only, mean±standard deviation, or mean value of data.

Table 3

Treede Grade and S-LANSS in the Neuropathic Pain Group

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S-LANSS, self-report of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale.

Table 4

Comparison of Visual Analogue Scale at Baseline and after Selective Nerve Root Block

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Values are presented as mean±standard deviation.

p-value < 0.05.

Notes

This paper was supported by Wonkwang University in 2013.

CONFLICTS OF INTEREST The authors have nothing to disclose.

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