The Outcomes of Selective Nerve Root Block for Disc Induced Lumbar Radiculopathy

Malays Orthop J. 2015 Nov;9(3):17-22. doi: 10.5704/MOJ.1511.002.

Abstract

Introduction: Use of Selective Nerve Root Block (SNRB) in lumbar region to relieve radicular pain along the course of a particular nerve is being practiced in the recent past. We observed and tabulated therapeutic outcomes of this procedure in management of radiculopathy induced by a prolapsed disc affecting a particular lumbar nerve root.

Methods: 40 patients with various grades of disc prolapse affecting a particular lumbar nerve root presenting with chronic radicular pain were identified irrespective of age and sex. All were injected with a combination of 40 mg of Methylprednisolone based suspension with local anaesthetic over the affected nerve root and results were analyzed.

Results: Those graded mild had 4.3 months relief and those graded moderate had 2.5 months relief. Those with severe disc prolapse had no relief except for the immediate postprocedural relief. Only 20% patients had relief up to 6 months.

Conclusion: Effect of SNRB is typically short acting in majority of patients and recurrence is expected. It creates a window period with reduced pain but of varied intervals depending on the pathology. It did not alter the prognosis in those with severe disease where surgery is well indicated. Level of Evidence - Level 4.

Keywords: Disc prolapse; Lumbar Radiculopathy; Radicular Pain; Selective Nerve Root Block.