J Korean Soc Spine Surg.  2019 Jun;26(2):40-49. 10.4184/jkss.2019.26.2.40.

When is the Optimal Time Point for Predicting the 1-Year Follow-up Outcome of Selective Nerve Root Block for Cervical Radiculopathy?

• Son WS
• Ahn MW
• Lee GW

• KMID: 2451312
• DOI: http://doi.org/10.4184/jkss.2019.26.2.40

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
In the current study, we aimed to (1) evaluate the early and late therapeutic effects of selective nerve root block (SNRB) for cervical radiculopathy, and (2) to determine the optimal time point for predicting the long-term effectiveness of cervical SNRB. SUMMARY OF LITERATURE REVIEW: Although SNRB is an important option for cervical radiculopathy, various studies of cervical SNRB have failed to specify its efficacy, especially long-term effectiveness.
MATERIALS AND METHODS
We retrospectively enrolled 35 patients with cervical radiculopathy who were regularly followed-up for at least 1 year after SNRB. Clinical outcomes were evaluated using a visual analogue scale (VAS) for pain intensity and the modified Kim's method for patient satisfaction at regular follow-up intervals. In the correlation analysis, stepwise multiple linear regression was used to identify selected and unselected factors.
RESULTS
The average VAS score decreased over time (p<0.05); the values just before the injection and at 1 week, 3 weeks, and 1 year of follow-up were 6.11, 3.29, 2.89, and 1.37, respectively. In the stepwise multiple regression analysis, the 1-week VAS score was related to the initial VAS score, the 3-week VAS score was related to the 1-week VAS score, and the last VAS score was related to the 3-week VAS score and symptom duration before the injection. The degree of satisfaction at the 1-year follow-up point was significantly associated with the 3-week VAS score (p=0.011).
CONCLUSIONS
The current study showed that pain intensity at the 3-week time point after cervical SNRB might be the optimal time point for predicting long-term effectiveness.

Keyword

Cervical spine; Radiculopathy; Selective nerve root block; Long-term effectiveness; Predictor

MeSH Terms

Follow-Up Studies*
Humans
Linear Models
Methods
Patient Satisfaction
Radiculopathy*
Retrospective Studies
Therapeutic Uses
Therapeutic Uses

Figure

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  Fig. 1. Flow diagram of patient enrollment.

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  Fig. 2. Provocation test using contrast.

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