J Korean Pain Soc.  1999 Nov;12(2):191-194.

Nerve Root Block with Corticosteroids, Hyaluronidase, and Local Anesthetic in the Failed Back Surgery Syndrome (FBSS)

• Lee KJ
• Han SG
• Yoon SH
• Kim JS
• Lee YS

Abstract

BACKGROUND: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics.
METHODS
The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection.
RESULTS
Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed.
CONCLUSIONS
This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

Keyword

Pain, failed back surgery syndrome (FBSS); Treatment, lumbar spinal nerve block; hyaluronidase

MeSH Terms

Adrenal Cortex Hormones*
Anesthetics, Local
Failed Back Surgery Syndrome*
Fibrosis
Fluoroscopy
Humans
Hyaluronoglucosaminidase*
Methylprednisolone
Retrospective Studies
Sciatica
Spinal Nerve Roots
Adrenal Cortex Hormones
Anesthetics, Local
Hyaluronoglucosaminidase
Methylprednisolone