Diagnostic lumbosacral segmental nerve blocks with local anesthetics: A prospective double-blind study on the variability and interpretation of segmental effects

Wolff, André; Groen, Gerbrand J.; Crul, B.J.P.

doi:10.1053/rapm.2001.21436

Cited by 46 publications

(62 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Considering that Head and Campbell (1900) had no cases of S1 herpes zoster eruptions and Foerster only two cases of S1 dorsal nerve root isolation, the evidence for S1 dermatome distribution from Nitta et al's study is likely to be significant. Furthermore, these findings for L5 and S1 are supported by Wolff et al (2001) who investigated the distribution of hypoalgesia by pinprick testing in a smaller number of patients (L5 ¼ 14, S1 ¼ 11) after local anesthetic spinal nerves block and the distribution of parasthesiae after electrical stimulation of mixed spinal nerves in patients with chronic low back pain.…”

Section: The Evidence Basementioning

confidence: 64%

“…These methods differ in which neural structure was studied-the dorsal root, mixed spinal nerve, or spinal cord segment-and whether tactile, pain, or temperature sensation were assessed. Two more reliable methods in humans include the recording of mixed spinal nerve sensory action potentials after electrical skin stimulation (Inouye and Buchthal, 1977) and mapping the area of sensory impairment after local anesthetic spinal nerve block (Poletti, 1991;Nitta et al, 1993;Wolff et al, 2001). …”

Section: The Evidence Basementioning

confidence: 99%

“…Both Nitta et al (1993) and Wolff et al (2001) evaluated mixed spinal nerves rather than dorsal roots. Ventral roots are known to contain afferent nerve fibers, some of which are pain fibers, although the function of others is uncertain (Hosobuchi, 1980).…”

Section: The Evidence Basementioning

confidence: 99%

See 2 more Smart Citations

An evidence‐based approach to human dermatomes

2008

View full text Add to dashboard Cite

The dermatome is a fundamental concept in human anatomy and of major importance in clinical practice. There are significant variations in current dermatome maps in standard anatomy texts. The aim of this study was to undertake a systematic literature review of the available evidence for the distribution of human dermatomes. Particular emphasis was placed on the technique of ascertainment, the location and extent of each dermatome, the number of subjects studied, and methodologic limitations. Our findings demonstrate that current dermatome maps are inaccurate and based on flawed studies. After selecting the best available evidence, a novel evidence-based dermatome map was constructed. This represents the most consistent tactile dermatomal areas for each spinal dorsal nerve root found in most individuals. In addition to highlighting the orderly arrangement, areas of consistency and clinical usefulness of dermatomes, their overlap and variability deserve greater emphasis. This review demonstrates the validity of an evidence-based approach to an anatomical concept.

show abstract

Section: The Evidence Basementioning

confidence: 64%

Section: The Evidence Basementioning

confidence: 99%

See 1 more Smart Citation

An evidence‐based approach to human dermatomes

2008

View full text Add to dashboard Cite

show abstract

“…62 Of the remaining 13 included in the Datta et al review 62 but excluded from our study, three studies [64][65][66] were excluded as they focused on cervical spine injections (see Table 21). Six studies 27,[67][68][69][70][71] were excluded from our review because it was impossible to reconstruct sensitivity and specificity or 2 × 2 tables of index test and reference standard results. Three studies 46,72,73 did not include a reference standard and were not considered diagnostic accuracy studies.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model

Beynon

Hawkins²,

Laing³

et al. 2013

Health Technol Assess

View full text Add to dashboard Cite

Reports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 09/111/01. The contractual start date was in August 2010. The draft report began editorial review in February 2012 and was accepted for publication in October 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health.

show abstract

“…He used fluoroscopic guidance from a postero-lateral approach to position the needle tip into the root sleeve with the use of radio-opaque dye and characteristic pain provocation [1]. Despite the introduction of CT, ultrasound and electrostimulation for guidance [2][3][4][5][6], selective nerve root blocks have changed little in technique and are still widely used today as a diagnostic tool [7].…”

Section: Introductionmentioning

confidence: 99%