A prospective study in management of lumbar radiculopathy patients with selective nerve root block

Background: Prolapsed Intervertebral Disc (PID) was considered to be the commonestcause of sciatica among many others. Though the presentation of sciatica wasparadoxical, in which, some people experienced sciatica without any disc prolapse onMRI/CT, whereas some people showed a prolapsed disc without experiencing any ofthe symptoms related to sciatica. This gave rise to different explanations that a discprolapse in itself , is not enough to cause sciatica, and there might be some localchemical agents that might be the causative factor due to their insulting attitude on thenerve roots.Objectives:To study the functional outcome of patients with Posterior LumbarIntervertebral disc prolapse (PLIVDP), Lumbar Canal Stenosis, andLumbar radiculopathy after Selective Nerve Root Block at thecorresponding level.Materials and Methods:A prospective cohort study on the functional outcome of patients with lumbarradiculopathy with Intervertebral disc prolapse or lumbar canal stenosis. Outcomemeasures used in this study are Owestry disability index score and Numerical ratingscale. All patients had taken an MRI scan, which was classified according to theMichigan state university classification. After initial check up, pre-anaestheticcheckup, selected patients were given Selective Nerve Root Block with MethylPrednisolone and local anaesthetic Bupivacaine. Patients were scored at Immediatepost Op, 3 weeks and 3 months after the injection was given and the data wascollected.Results:A total of 127 patients were given Selective Nerve Root Block in the studyperiod. Patients that were aged from 20-80 years were included. Average pre-injection ODI scores (in percent) were 75.24, at 1 month 20.52and at 4 months 19.86, with a p value of <0.001. Mean NRS ratings pre injectionwere 8.73, Immediate post op were 1.89, at 4 weeks it was 1.48 and 4 months 1.27. MeanSLR (in degrees) Pre Injection was 48.3, Immediate was 80.00, at 4 weeks was 80.2 and at 4 months was 80.5.Conclusion:Selective Nerve Root Block is a good therapeutic procedure for pain management in the patients with Lumbar radiculopathy, and it can be used as a standard procedure, before advising the patient for any form of surgery Keywords: SNRB, Lumbar canal stenosis, Sciatica, Radiculopathy