Therapeutic effects of selective nerve root block in cases of lumber PIVD - A prospective study

Introduction: Chronic lumbar radiculopathy is defined as a clinical syndrome of back and leg pain companied by sensory, reflex, or motor deficits in a nerve root distribution lasting for more than 12 weeks. Lumbar radiculopathy mostly occurs due to a prolapsed disc. Both surgical and non-surgical treatments are available. This prospective analytic study was designed to assess the efficacy of selective nerve root block with corticosteroids in the management of pain associated with prolapsed lumbar intervertebral disc that didn't get relief from non-surgical pharmacological treatment. Materials and Methods: 40 Known cases of lumbar PIVD not responding to pharmacological treatment were given c- arm guided root block for respective nerve root and the results were evaluated using the visual analogue scale (VAS), Oswestry Disability Scale (ODI)and straight leg raising (SLR) test over the period of 1,3,6, and 12 months. Results: Total of 40 patients were included in the study out of which 29 (72.5%) were male and 11 (27.5%) were female. Average Age was 36.73±10.8 ranging 18–62 years. The average duration of pain was 13.08±4.1 months. The initial VAS was 7.65±0.5 which was reduced to 4.07±0.9 at final follow up after 1 year of treatment. The average SLR was increased to average 65.8 ± 5.3% t final follow up from average 41 ± 12.8% at initiation of treatment. The initial ODI score was78.20±2.8 which was reduced to 41.70±5.5 at final follow up. All the parameters taken to assess the therapeutic effects of SNRB showed statistically significant change from initial values to final values. Conclusion: Our study has shown that selective nerve root block is an easy and safe method with better short-term, mid- term, and long-term pain relief and improvement in functional disability in cases of lumbar intervertebral disc herniation. It can be given by a trained interventionist /orthopedic surgeon.