The Role of Selective Nerve Root Block in the Treatment of Lumbar Radicular Leg Pain

Mymensingh Med J. 2016 Jan;25(1):141-7.

Abstract

The objective of this retrospective study was to investigate the clinical effectiveness of nerve root blocks (i.e., periradicular injection of Lidocaine and triamcinolone) for lumbar monoradiculopathy in patients with a mild neurological deficit in National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh from March 2014 to December 2014. We Included 24 patients (32-74 years) with a minor sensory/motor deficit and an unequivocal MRI finding (18 disc herniations, 6 foraminal stenosis) treated with a selective nerve root block. Based on the clinical and imaging findings, surgery (decompression of the nerve root) was justifiable in all cases. Seventeen patients (87%) had rapid (1-4 days) and substantial regression of pain, four required a repeat injection. Sixty percent (60%) of the patients with disc herniation or foraminal stenosis had permanent resolution of pain, so that an operation was avoided over an average of 6 months (2-9 months) follow-up. Nerve root blocks are very effective in the non-operative treatment of minor monoradiculopathy and should be recommended as the initial treatment of choice for this condition.

MeSH terms

  • Adult
  • Aged
  • Bangladesh
  • Constriction, Pathologic / drug therapy
  • Humans
  • Intervertebral Disc Displacement / drug therapy*
  • Leg / physiopathology
  • Lidocaine / therapeutic use*
  • Lumbar Vertebrae / physiopathology*
  • Middle Aged
  • Nerve Block
  • Pain Management*
  • Radiculopathy
  • Retrospective Studies
  • Triamcinolone / therapeutic use*

Substances

  • Triamcinolone
  • Lidocaine