Journal of Pain Research (Nov 2020)

The Efficacy of Therapeutic Selective Nerve Block in Treating Lumbar Radiculopathy and Avoiding Surgery

  • Kanaan T,
  • Abusaleh R,
  • Abuasbeh J,
  • Al Jammal M,
  • Al-Haded S,
  • Al-Rafaiah S,
  • Kanaan A,
  • Alnaimat F,
  • Khreesha L,
  • Al Hadidi F,
  • Al-Sabbagh Q

Journal volume & issue
Vol. Volume 13
pp. 2971 – 2978

Abstract

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Tareq Kanaan,1 Rami Abusaleh,2 Jumanah Abuasbeh,2 Maryam Al Jammal,2 Sara Al-Haded,2 Sara Al-Rafaiah,2 Ali Kanaan,2 Fatima Alnaimat,3 Lubna Khreesha,4 Fadi Al Hadidi,5 Qussay Al-Sabbagh1 1Division of Neurosurgery & Spine Unit, Special Surgery Department, University of Jordan, Amman, Jordan; 2School of Medicine, University of Jordan, Amman, Jordan; 3Internal Medicine Department, University of Jordan, Amman, Jordan; 4Special Surgery Department, University of Jordan, Amman, Jordan; 5Division of Orthopedic Surgery & Spine Unit, Special Surgery Department, University of Jordan, Amman, JordanCorrespondence: Tareq KanaanDivision of Neurosurgery & Spine Unit, Special Surgery Department, University of Jordan, Queen Rania St, Amman 11942, JordanTel +962 799731700Email [email protected]: Selective nerve root block (SNRB) is a procedure that can be used as a diagnostic or a therapeutic method. SNRB can be used in multiple sites, including cervical and lumbar . Our study aims to investigate the clinical effectiveness of the use of fluoroscopically guided therapeutic selective nerve root block as a non-surgical symptom management of lumbar radiculopathy.Patients and Methods: This is a prospective study of therapeutic nerve root block in 76 patients with low back pain and/or sciatica at Jordan University Hospital. Data was collected by independent clinical interviewers, and visual analogue score (VAS) was used to measure pain severity.Results: A total of 76 patients, 25 (32.8%) males and 51 (67.2%) females, underwent SNRB. 69 (90.7%) patients improved immediately after the procedure. Out of the total, 22 (28.9%) patients showed a long-term relief of symptoms and did not experience any recurrence during the three months of follow-up, while 47 (61.8%) experienced a recurrence of pain. In patients experiencing recurrence of symptoms, 35 needed surgery.Conclusion: Therapeutic SNRB is an important procedure in the pain management of patients with lumbar radiculopathy caused by lumbar disc prolapse and foraminal stenosis. Our study showed that avoidance of surgery was achieved in up to 54% of patients; pain relief for at least 6 months was achieved in up to 29% of patients after a single SNRB. This makes it a very good second line of management after conservative treatment and a possible method to delay, and sometimes cease, the need for surgery.Keywords: sciatica, sacroiliac joint, SIJ, lumbar disc herniation, facet joint, peri-radicular therapy, PRT, lumbar disc prolapse, LDP

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