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

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2014, 21(3), pp.109-115
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

Dae Ho Ha 1,  Kim Yu Mi 1,  Dae Moo Shim 1,  Sung Kyun Oh 1,  Kim chang su 2,  김상열 1

1원광대학교
2고신대학교(의대)

Accredited

ABSTRACT

Study Design: Retrospective study. Objectives: We reported the therapeutic usefulness of a selective nerve root block (SNRB) for patients with a single level spinalstenosis. Summary of Literature Review: Selective nerve root block for the radiculopathy due to lumbar disc herniation, spinal stenosis, andspondylolisthesis have been reported frequently. Materials and methods: We retrospectively examined 44 patients with single-level spinal stenosis, for whom surgical treatment wasconsidered due to the failure of other conservative treatments from January 2005 to January 2010. All 44 patients were admitted forsurgical 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 proceduresby 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 followup(p=0.072~0.14, p=0.06). Generally, the operation group had good results until 1 year after operation and had better tendency forimprovement. 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 sentenceneeds 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 sentenceneeds 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 tothe conservative treatment. Thus it is one of options for the refractory spinal stenosis.

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