Lumbar Nerve Root Sleeve Injections in Painful Disorders of the Lumbar Spine: Short Term Results

Shim, Jae Chol; Kim, Kyo Sang; Suh, Jung Kook; Yoo, Hee Koo; Seung, Ik Sang

Abstract

BACKGROUND: Nerve root sleeve injection has become popular in the treatment of lumbar radicular complaints. However reported data on nerve root sleeve injection is more of a technical nature. The present study was designed to evaluate the therapeutic success of a fluoroscope guided nerve root sleeve injection of local anesthetics and corticosteroids.
METHODS
Fifty seven patients who had persistent radicular pain and/or low back pain that is resistant to conservative treatment were treated with fluoroscope guided injection therapy. 0.125% bupivacaine 2.5 ml and triamcinolone 40 mg were injected at intervals of 2 - 4 weeks. Before and after treatment and at follow up, a visual analogue scale (VAS) was measured. Treatment success was evaluated on a ratio based on the visual analogue scale (post-treatment VAS/pre-treatment VAS) and categorized as following (good improvement = > 70%, moderate improvement = 70 50%, no improvement = < 50%).
RESULTS
Short-term good and moderate improvement was observed in 46% of the patients with radiating pain and/or lower back pain, and in 43% of patients with lower back pain only.
CONCLUSIONS
Results indicated that nerve root sleeve injections of corticosteroids done under fluoroscopic guidance as an outpatient procedure was effective and safe in our study and may deserve to be used as part of the conservative management of lumbar radiculopathy before resorting to more invasive methods.