The Usefulness of Selective Spinal Nerve Root Block

Dae Moo Shim; Tae Kyun Kim; Ha Heon Song; Soo You Son; Jae Duek Cho

doi:10.4184/jkss.2004.11.1.48

Journal List > J Korean Soc Spine Surg > v.11(1) > 1035639

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Shim, Kim, Song, Son, and Cho: The Usefulness of Selective Spinal Nerve Root Block

Original Article

Journal of Korean Spine Surg 2004;11(1):48-54.

Published online: 21 February 2004

DOI: https://doi.org/10.4184/jkss.2004.11.1.48

The Usefulness of Selective Spinal Nerve Root Block

Dae Moo Shim, M.D., Tae Kyun Kim, M.D., Ha Heon Song, M.D., Soo You Son, M.D., Jae Duek Cho, M.D.

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

Address reprint requests to Dae Moo Shim, M.D. Department of Orthopaedic Surgery, School of Medicine, Wonkwang University Hospital #344-2 Sinyoung-dong, Iksan, Chunbuk, 570-711, Korea Tel: 82-63-850-1255, Fax: 82-63-850-1257, E-mail: osshim@wonkwang.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

A retrospective study on the usefulness of selective spinal nerve root block among lumbar herniated intervertebral disc (HIVD), spinal stenosis and postoperative syndrome over 10 years.

Material and Method

From a total 1195 patients, whose symptoms were not improved by conservative treatment, 505 treated by selective nerve root block were divided into 3 groups; 150 (29.7%) with HIVD, 313 (62.0%) with spinal stenosis and 42 with postoperative syndrome, and were followed up from Oct. 1992 to Dec 2001. The degree of pain and activity were evaluated by a visual analogue scale method at the out- patient department or through telephone interviews.

Results

The endresults of selective spinal nerve root block, with more than 50% reduction in pain occurred in 380 (75.3%) of the 505 patients. The effectiveness was greater in young patients with HIVD than elderly patients with spinal stenosis. A fter discharge, 160 patients (31.7%) needed no other treatment: 14 (31.0%) with an extrusion type HIVD and 17 (20.0%) with spondylolisthesis. The only 98 patients (19.4%) needed a surgical procedure after selective spinal nerve root block.

Conclusion

Selective spinal nerve root block in patients with lower back and radiating pain is a valuable conservative treatment to quickly improved symptoms and avoid surgical procedures and the continuous administration of drugs.

Keywords: HIVD, spinal stenosis, postoperative syndrome, spinal nerve root block

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Table 1.

Disease and sex distribution of the patients

	Male	Female	Total
HIVD	73	77	150
Spinal stenosis	79	234	313
Postoperative syndrome	8	34	42
Total	160	345	505

Table 2.

Disease and age distribution of the patients

	20 ~ 29	30 ~ 39	40 ~ 49	50 ~ 59	over 60	Total
HIVD	45	56	28	16	5	150
Spinal stenosis	3	11	34	86	179	313
Postoperative syndrome	1	1	5	7	28	42
Total	49	68	67	109	212	505

Table 3.

Symptom distribution

	less than 1 month	1 ~ 3 mos	3 ~ 6 mos	6 ~ 12 mos	over 12 mos	Total
HIVD	33	22	11	16	68	150
Spinal stenosis	29	29	23	78	154	313
Postoperative syndrome	11	4	4	4	19	42
Total	73	55	38	98	241	505

mos: months

Table 4.

Number of nerve block according to disease

	1 ~ 2	3 ~ 4	5 ~ 6	7 ~ 8	over 9	Total
HIVD	49	62	33	6	0	150
Spinal stenosis	55	139	82	30	7	313
Postoperative syndrome	13	19	7	3	0	42
Total	117	220	122	39	7	505

Table 5.

Reduction of pain after nerve block (Visual analogue scale)

	0 ~ 25%	25 ~ 50%	50 ~ 75%	75 ~ 100%	Total
HIVD	14	30	75	31	150
Spinal stenosis	31	36	171	75	313
Postoperative syndrome	7	7	21	7	42
Total	52	73	267	113	505

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