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Abstract
Objectives
To analyze the serial results of selective nerve root blocks in herniated lumbar disc patients.
Literature Review Summary
To our knowledge there has been no study demonstrating the serial efficacy of root blocks for patients with a herniated lumbar disc only.
Materials and Methods
Selective nerve root blocks were performed in 36 patients who had a lumbar disc herniation only, with radiculopathy, between November 2002 and A pril 2003. The diagnoses were made by CT or MRI, which agreed with the symptoms and physical examinations. There were 31 men and 5 women, with a mean age of 28.2 years. The mean interval between the onset and procedure was 7.6 weeks, ranging from 1to 26 weeks. Mono- and double- segment injections were used in 18 cases, respectwely. The straight leg raising angle, visual analogue pain scale, and motor and sensory functions were inves-tigated before, immediately, 2 days, and 1 and 3 months after the procedure.
Results
The mean straight leg raising angle improved significantly, from 28 ± 9° to 53± 18°, immediately, and was maintained until 3 months after the procedure (P<0.001). The visual analogue pain scale was also improved, from 4.6± .9 to 2.0± 1.5, immediately, and was maintained until 3 months after the procedure (P<0.001). Two of ten patients with motor weakness, and six of eighteen with sensory deficit were improved. There was no procedure related complication; however, surgical treatment was performed in two patients who showed no improvement until 3 months.
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Fig. 1.
Sixty-nine percents of patients showed improvement of straight leg raising angle more than 20 degrees immediately after injection. At 3 months, this improvement was maintained in 53 percents of patients.
Fig. 2.
Seventy-eight percents of patients represented satisfactory result at 2 days. Even though some of them was aggravated, 69 percents showed satisfactory result at 3 months.
Table 1.
Criteria of subjective satisfaction
| Criteria | |
|---|---|
| Excellent | Completely satisfied |
| Good | Satisfied, lesser complaints |
| Fair | Not satisfied, partly incapacitated |
| Poor | Completely incapacitated for work due to chronic back pain or sciatica |
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