J Korean Soc Spine Surg.  2014 Sep;21(3):109-115. 10.4184/jkss.2014.21.3.109.

Effectiveness of Selective Nerve Root Block for the Patient with a Single Level Lumbar Spinal Stenosis who is on the Operation Schedule

Affiliations
  • 1Department of Orthopedic Surgery, School of Medicine, Wonkwang University Hospital Iksan Korea. castkim@daum.net
  • 2Department of Orthopedic Surgery, School of Medicine,Kosin University Hospital Korea.

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
We reported the therapeutic usefulness of a selective nerve root block (SNRB) for patients with a single level spinal stenosis. SUMMARY OF LITERATURE REVIEW: Selective nerve root block for the radiculopathy due to lumbar disc herniation, spinal stenosis, and spondylolisthesis have been reported frequently.
MATERIALS AND METHODS
We retrospectively examined 44 patients with single-level spinal stenosis, for whom surgical treatment was considered due to the failure of other conservative treatments from January 2005 to January 2010. All 44 patients were admitted for surgical decompression. Selective nerve root block was done just before a final decision of surgical procedure; patients with his or her 50% or more pain reduction could avoid surgery.
RESULTS
In fourty-four cases, twenty-seven pateints underwent a surgical operation. Seventeen patients avoided surgical procedures by successful SNRB. As a result of a 3 year follow-up, the VAS score was significantly and continuously low on the operation group (p=0.02~0.03). K-ODI and Roland-Morris Disability scores were low in both groups until 1 year after the operation and SNRB procedure (p=0.026~0.042, p=0.03), but there was no statistically significant difference beteween the two groups after 2 years upon follow-up (p=0.072~0.14, p=0.06). Generally, the operation group had good results until 1 year after operation and had better tendency for improvement. The data displayed a high probability of surgical treatment among the patients with foraminal stenosis (p=0.039) highlight - this sentence says there is no difference after 1 year and there is still no difference after 2 years. If this is true, the sentence needs to be rewritten so that it says both times show no difference. If there is a difference between 1 year and 2 year then the sentence needs to be rewritten to make this more clear. The next sentence seems to say they are different.
CONCLUSIONS
Selective nerve root block avoided the surgical intervention in 39% of the patients with the spinal stenosis refractory to the conservative treatment. Thus it is one of options for the refractory spinal stenosis.

Keyword

Spinal stenosis; Root block; Foraminal stenosis

MeSH Terms

Appointments and Schedules*
Constriction, Pathologic
Decompression, Surgical
Follow-Up Studies
Humans
Radiculopathy
Retrospective Studies
Spinal Stenosis*
Spondylolisthesis

Reference

1. MacNab I. N��ativ� di�c �xpl�rati�n An analy�i� �f th� ca���� �f n�rv�-r��t inv�lv�m�nt in �ixty-�i�ht pa-ti�nt�. Th� J��rnal �f B�n� and J�int S�r��ry (Am�rican). 1971; 53:891–903.
2. D��l�y J, McBr��m R, Ta��chi T, Macnab I. N�rv�.
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