Study of nerve root block procedure as a diagnostic and therapeutic aid in lumbosacral radiculopathy

Salunkhe, Rahul; Pisal, Tushar; Hira, Yuvraj Singh; Singh, Ashutosh Kumar; Patel, Jay; Goud, Sunny Sajitsing

doi:10.4103/0970-5333.186470

Cited by 2 publications

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“…However initial mean VAS back was 2.6 ± 1.4 which came down to 1.29 ± 1.12 with 56.9% improvement at 1 month, 0.88 ± 0.81 (66.15% improvement) at 6 months and 0.71 ± 0.72 with 72.7% improvement at 1year follow up. Also, Salunkhe et al [33] analyzed their results on VAS, where at the end of 3 months, 41 (82%) of patients enjoyed excellent (decrease in pain scale ≥ 5) results, 4 (8%) had good (decrease in 3-4 points) results, fair (1-3 points decrease in pain scale) results were seen in 2 (4%), and poor (no improvement) results were seen in 3 (6%). Similarly, in Weiner and Fraser [15] study 22 of 28 patients (79%) had a substantial and permanent pain reduction during 1-10 years follow-up.…”

Section: Discussionmentioning

confidence: 99%

A study on effectiveness of selective nerve root blocks in lumbar radiculopathies

Vashishtha¹,

Singh²,

Verma³

et al. 2019

Int. J. Orthop. Sci.

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Background: Low back pain is one of the most common reason for visit to a doctor & young age morbidity, disability, work absenteeism constitutes almost 40% of all occupational risk factors. Lumbar radiculopathy with or without neurological deficits are managed with variety of conservative or operative measures, and generally recovers well. Selective nerve root blocks (SNRBs) having diagnostic or therapeutic use, are popular and advantageous to avoid uncertain potential surgical complications. Aim of this study is to establish therapeutic efficacy and evaluate complications following selective nerve root blocks. Materials and Methods: The present study was a randomized, prospective study carried out from August 2016 to March 2018, on 50 cases satisfying the inclusion criteria following complete assessment, received selective nerve root blocks. Patients were assessed for pain relief and disability reduction. Result: Evaluated with VAS and ODI score. In study, immediate improvement of VAS score was 33.04%, 45.3% at 1week, 59.8% at 4weeks and 66.9% after 3months. Reduction in ODI score was 37.7% till 1week, 54.8% till 4weeks and 66.8% till 3months follow up periods. Conclusion: SNRB is an important, effective, less expensive and less invasive treatment modality to provide lasting therapeutic benefit, allowing the patient to participate in life style modifications, physiotherapies and early resumption of routine activities.

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Section: Discussionmentioning

confidence: 99%

A study on effectiveness of selective nerve root blocks in lumbar radiculopathies

Vashishtha¹,

Singh²,

Verma³

et al. 2019

Int. J. Orthop. Sci.

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First case of mechanical compression by methylprednisolone crystals following transforaminal lumbar nerve root block for left sciatic pain leading to hyperesthesia and progressive weakness: A case report

Moghamis

Ansari

Abdelsalam

et al. 2021

International Journal of Surgery Open

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Introduction: Lumbosacral nerve root blocks and epidural corticosteroid injections are commonly used for short-term pain relief among patients with degenerative spinal disc disease. Serious complications following these injections are rare, and there are only a few published papers on this subject. It is important that spine surgeons are aware of the potential complications, and the possible factors that contribute to such complications. Presentation of case: 32-year-old Lebanese female presented with progressive weakness and hyperesthesia following a transforaminal lumbar nerve root corticosteroid particulate injection. The case was managed by surgical lumbar decompression. Discussion: Neurological complications following transforaminal/selective nerve root block are the most feared of all possible associated complications with epidurals blocks. It has been hypothesized that such a complication is mainly due to a spinal cord infarct from corticosteroid crystal. However, there are no previous reports that such progressive weakness and hyperesthesia could be due to the mechanical compression caused by corticosteroid particulate crystals themselves as confirmed in the current case. Conclusions: Progressive weakness and hyperesthesia following nerve root block could be due to the effect of the corticosteroid particles used in the injectate. Such complications could be simply avoided by the use of more dilutional volume of the local anaesthetic agent and/or using a non-particulate corticosteroid in order to avoid the adherence of the corticosteroid crystals to the nerve root sheath. This is the first case of post-nerve root block neurological complications due to mechanical compression caused by corticosteroid particulate crystals. Highlights

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Study of nerve root block procedure as a diagnostic and therapeutic aid in lumbosacral radiculopathy

Cited by 2 publications

References 0 publications

A study on effectiveness of selective nerve root blocks in lumbar radiculopathies

A study on effectiveness of selective nerve root blocks in lumbar radiculopathies

First case of mechanical compression by methylprednisolone crystals following transforaminal lumbar nerve root block for left sciatic pain leading to hyperesthesia and progressive weakness: A case report

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