The Usefulness of Selective Nerve Root Block for Failed Back Surgery Syndrome

Dae Moo Shim; Tae Kyun Kim; Sung Kyun Oh; Seung Yeop Song; Bong Jun Jang; Yu Mi Kim

doi:10.4055/jkoa.2017.52.2.185

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This article has been corrected. See "Corrigendum: The Usefulness of Selective Nerve Root Block for Failed Back Surgery Syndrome" in Volume 54 on page 90.

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Shim, Kim, Oh, Song, Jang, and Kim: The Usefulness of Selective Nerve Root Block for Failed Back Surgery Syndrome

Original Article

Journal of the Korean Orthopaedic Association 2017; 52(2): 185-191.

Published online: 19 April 2017

DOI: https://doi.org/10.4055/jkoa.2017.52.2.185

The Usefulness of Selective Nerve Root Block for Failed Back Surgery Syndrome

Dae Moo Shim, M.D., Tae Kyun Kim, M.D., Sung Kyun Oh, M.D., Seung Yeop Song, M.D., Bong Jun Jang, M.D., Yu Mi Kim, M.D.

Department of Orthopaedic Surgery, Wonkwang University School of Medicine, Iksan, Korea.

Correspondence to: Yu Mi Kim, M.D. Department of Orthopaedic Surgery, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 54538, Korea. TEL: +82-31-390-2224, FAX: +82-31-390-2227, castkim@daum.net

Received 10 February 2015 Revised 12 October 2015 Accepted 17 October 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To retrospectively evaluate the improvement of symptoms and diagnosis using selective nerve root block (SNRB) for radiating pain after spine surgery.

Materials and Methods

From October 2012 to October 2013, 112 patients with failed back surgery syndrome (41 male and 71 female, with the mean age of 62.4 years and range of 35 to 78 years), who were admitted and underwent SNRB, were included. All patients were followed-up for more than 12 months. Three groups were classified: Group 1 included patients with no improvement or aggravation of symptoms, group 2 included those with improvement of radiating pain, and group 3 included those with recurrence of radiating.

Results

Among the 112 patients, there were 15 patients in group 1, 59 patients in group 2, and 38 patients in group 3. Laminectomy was the highest surgical procedure, inducing failed back surgery syndrome. In group 2, the occurrence of failed back surgery syndrome was higher in case that radiating pain was complained more than 1 year before the first surgery. There is statistically significant symptom improvement in accordance with the visual analogue scale and Korean version of Oswestry disability index on every group after SNRB (p<0.05).

Conclusion

It is considered that SNRB is expected to improve the symptoms and to find the cause of symptoms as a diagnostic value even after spine surgery.

Keywords: failed back surgery syndrome, postoperative radiating pain, selective nerve root block

Figures and Tables

Table 1

Methods of Initial Operations Demography

Values are presented as number (%).

Table 2

Duration of the Symptom prior to the 1st Surgery

Values are presented as number (%). Group 1 included patients with no improvement or aggravation of symptoms, group 2 included those with improvement of radiating pain, and group 3 included those with recurrence of radiating.

Table 3

Comparison of Symptom Duration within the Two Groups

Values are presented as number only. Group 1 included patients with no improvement or aggravation of symptoms, group 2 included those with improvement of radiating pain. High occurrence of failed back surgery syndrome when radiating symptom duration is more than 1 year in group 2.

Table 4

Comparison of Reoperation within the Two Groups

Values are presented as number only. Group 1 included patients with no improvement or aggravation of symptoms, group 2 included those with improvement of radiating pain. Group 1 shows statistically high incidence of reoperation even after the nerve root block after the first operation.

Table 5

Clinical Outcomes of Each Group, VAS and K-ODI

Values are presented as mean±standard deviation. Group 1 included patients with no improvement or aggravation of symptoms, group 2 included those with improvement of radiating pain. K-ODI was improved in all groups. VAS, visual analogue scale; K-ODI, Korean version of Oswestry disability index; F/U, follow-up.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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