Functional Outcome of Selective Transforaminal Nerve Root Block for Lumbar Radiculopathy in Intervertebral Disc Prolapse

Kabilan, M (2020) Functional Outcome of Selective Transforaminal Nerve Root Block for Lumbar Radiculopathy in Intervertebral Disc Prolapse. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: Lumbar disc prolapse characterized by symptomatic disc herniation or typical sciatica is a major challenge for health care. The lifetime prevalence of radiculopathy due to a herniated lumbar disc is estimated to be around 4%in females and 5%in males. A diagnosis of lumbar radiculopathy was made based on medical history, symptoms, and standardized physical examination. One third of all patients with lumbar disc syndrome had been previously hospitalized with it and one fifth of the patients had undergone lumbar surgery. OBJECTIVE: Selective transforaminal nerve root block is an interventional procedure targeting the selected nerve roots in a failed medical management of lumbar disc herniation. This study delineates the functional outcome of transforaminal epidural block using the subpedicular approach in patients complaining of lumbar radicular pain and to investigate the short-term effects upto a period of One year. STUDY DESIGN: Prospective, observational cohort study. MATERIALS AND METHODS: The study was conducted at Government Royapettah Hospital, Chennai and included 60 patients with INTERVERTEBRAL DISC PROLAPSE WITH LUMBAR RADICULOPATHY who fit the inclusion criteria. These patients with failed conservative management for lumbar disc herniation treated with selective nerve root block under fluoroscopic guidance in an aseptic manner. Patients were periodically followed up till One year. RESULTS: A Total of 60 patients underwent SNRB. 43 patients had good pain relief maintained till 1 year (43/60, 71.8% efficacy). 17 patients either did not have adequate pain relief, out of which 3 had technical problems during injection and 14 had a temporary period of relief followed by severe pain (n ¼ 14). Out of 17 patients, 3 patients underwent surgery at a mean of 5 weeks after the failed NRB. In none of the failed patients second injection was tried. Factors including age (P= 0.41), sex (P=0.31), side of pain (P=0.19), level of lesion (L3- 4,L4-5 and L5 -S1) (P=0.54), previous attacks of sciatica and other MRI Findings (disc type and position, level of degeneration) (P=0.62) were not predictive CONCLUSION: The immediate response to transforaminal epidural steroid injection was satisfactory and has a considerable pain free life style over a short term of One year and its outcome for a long term pain relief has to be further evaluated in coming days. We conclude it is a reasonably safe procedure to provide shortterm pain relief.

Item Type: Thesis (Masters)
Additional Information: 221712153
Uncontrolled Keywords: Functional Outcome, Selective Transforaminal Nerve Root Block, Lumbar Radiculopathy, Intervertebral Disc Prolapse.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 13 Feb 2021 15:39
Last Modified: 13 Feb 2021 15:39

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