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Abstract
Objectives
To investigate the usefulness of selective nerve root block (SNRB) as a prognosis predictor of a lumbar disc herniation.
Summary of Literature Review
The biochemical factors of radiculopathy, as opposed to the biomechanical factors, are more reversible and responsive to a corticosteroid injection.
Materials and Methods
Fifty patients underwent SNRB for the radiculopathy caused by a herniated lumbar disc and were followed for at least 1 year. The straight leg raising (SLR) angle, visual analog scale (VA S) and the patients' subjective satisfaction, using the Weber criteria, were initially investigated, and again at 1 week and 1 month after the procedure, and finally at the final follow- up. The patients were divided into two groups according to the final satisfaction. Group 1 (satisfactory prognosis, N=32) had Excellent/Good results at the final follow- up, whereas Group 2(unsatisfactory prognosis, N=18) had Fair/Poor final results, or underwent surgical treatment. The improvements in the SLR and V A S at 1 week and 1month were compared between two groups. The subjective satisfaction each time was compared to the final outcome; the relative risks were also calculated.
Results
The improvements in the SLR and VA S for Group 1 were significantly better than those for Group 2 at both 1 week and 1 month (P<0.05). Those patients with Excellent/Good results at 1 week and 1month manifested satisfactory final outcomes (P<0.05). The risks of the patients with Fair/Poor results at 1 week and 1 month manifesting unsatisfactory final outcomes were 6.8 and 15.2 times higher than those with Excellent/Good results.
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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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