Pain Relief After Selective Nerve Root Block as a Predictor of Postoperative Functional Outcome in Patients with Degenerative Lumbar Spinal Stenosis Patients Undergoing Decompressive Surgery

Sangbong Ko; ChungMu Jun; Woo-Kie Min; Eunseok Son; Sukjoong Lee; Gun Woo Lee; Hyunseung Yoo; Daegu Spine Study Group (DGSSG)

doi:10.1097/BRS.0000000000004216

Pain Relief After Selective Nerve Root Block as a Predictor of Postoperative Functional Outcome in Patients with Degenerative Lumbar Spinal Stenosis Patients Undergoing Decompressive Surgery

Spine (Phila Pa 1976). 2022 May 1;47(9):666-671. doi: 10.1097/BRS.0000000000004216. Epub 2021 Aug 30.

Authors

Sangbong Ko¹, ChungMu Jun¹, Woo-Kie Min², Eunseok Son³, Sukjoong Lee³, Gun Woo Lee⁴, Hyunseung Yoo⁵; Daegu Spine Study Group (DGSSG)

Affiliations

¹ Department of Orthopaedic Surgery, School of Medicine, Daegu Catholic University Hospital, Daegu Catholic University, Daegu, South Korea.
² Department of Orthopaedic Surgery, School of Medicine, Kyung- pook National University Hospital, Kyungpook National University, Daegu, South Korea.
³ Department of Orthopaedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, South Korea.
⁴ Department of Orthopaedic Surgery, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, South Korea.
⁵ Department of Orthopaedic Surgery, Daegu Fatima Hospital, Daegu, South Korea.

PMID: 34468438
DOI: 10.1097/BRS.0000000000004216

Abstract

Study design: Retrospective study of data collected prospectively.

Objective: To investigate changes in the degree of lower leg radiating pain (LLRP) after selective nerve root block (SNRB) and to evaluate associations of this change with postoperative improvements in symptom severity, functional outcomes, and quality of life.

Summary of background data: SNRB is routinely performed as an initial treatment for lumbar foraminal or lateral recess stenosis with LLRP. The degree of improvement after SNRB has been suggested to predict the improvement in postoperative pain and functional outcomes. However, there have been no studies on the predictive value of this parameter.

Methods: We enrolled 60 patients who underwent SNRB followed by decompressive surgery. They were divided into three groups. The degree of improvement was evaluated as a percentage of the pre-injection values. Functional outcomes of the spine were assessed using the Oswestry Disability Index (ODI) and Roland-Morris Disability Questionnaire (RMDQ). Quality of life was assessed using the 36-item Short Form Survey (SF-36) physical component score (PCS) and mental component score (MCS). The degree of LLRP was measured preoperatively and at 6, 12, and 24 months after surgery. These functional outcomes were evaluated preoperatively and at 12 and 24 months after surgery.

Results: The improvement in LLRP in the short term (6 hours after SNRB) was found to be statistically significantly associated with the improvement in LLRP at 12 months after SNRB (P = 0.044, correlation coefficient = 0.261). No relationship between pain improvement after SNRB and functional outcome was identified.

Conclusion: The degree of improvement in symptoms 6 hours after SNRB can predict the degree of improvement in LLRP at 12 months after surgery. However, symptomatic improvement after SNRB does not predict postoperative functional outcome or quality of life.Level of Evidence: 4.

MeSH terms

Disability Evaluation
Humans
Lumbar Vertebrae / surgery
Pain, Postoperative
Quality of Life
Retrospective Studies
Spinal Stenosis* / complications
Spinal Stenosis* / surgery
Treatment Outcome