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Abstract
Purpose
The selective spinal nerve root block is one of the preoperative diagnostic tool to identify and confirm the lesion site of primary cause of pain. The purpose of this study was to ascertain the correlation between diagnostic selective spinal nerve root blocks and outcome following surgical treatment of selected levels of both lumbar herniated intervertebral disc (HIVD) and spinal stenosis.
Material and Method
In a total 341 selective nerve root blocks in 169 patients who were diagnosed as lumbar HIVD and spinal stenosis from Jan. 1993 to Jun. 1997 with performed in a retrospective study, two groups of patients were chosen for this study. The result of pain change of selective nerve root block were judged by Denis’ pain scale, the endresult selective spinal nerve root and operative treatment used by Kim's criteria.
Result
1. The endresults of selective spinal nerve root block, excellent and good results were 64 cases (67.3%) in lumbar HIVD group and 50 cases (67.5%) in spinal stenosis group. The endresults of selective spine surgery, at last follow up, excellent and good results were 82 cases (86.2%) in lumbar HIVD group and 56 cases (75.7%) in spinal stenosis group.
Result
2. The predictive value of selective spinal nerve root block was 68.4% in lumbar HIVD group and 74.3% in spinal stenosis group. In addition, statistical analysis with regression analysis, to show any significant correlation between the selective spinal nerve root block results and the outcome of operative treatment, especially in spinal stenosis group.
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Table 1.
Pain scale (by Denis et al 1984)
Table 2.
Criteria for clinical results (Kim, 1986)
Table 3.
End-result of selective nerve root block (Kim's criteria)
| HIVD∗ | spinal stenosis | |
|---|---|---|
| Excellent | 10 (10.5%) | 11 (14.8%) |
| Good | 54 (56.8%) | 39 (52.7%) |
| Fair | 27 (28.4%) | 14 (18.9%) |
| Poor | 4 (4.3%) | 10 (13.6%) |
| Total | 95 (100%) | 74 (100%) |
Table 4.
End-result of operative treatment (Kim's criteria)
| HIVD∗ | spinal stenosis | |
|---|---|---|
| Excellent | 20 (21.0%) | 10 (13.6%) |
| Good | 62 (65.2%) | 46 (62.1%) |
| Fair | 11 (11.5%) | 12 (16.2%) |
| Fair Poor | 11 (11.5%) 2 (2.3%) | 12 (16.2%) 6 (8.1%) |
| Total | 95 (100%) | 74 (100%) |
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