Selective extraforaminal nerve root block for management of lumbar radiculopathy

Vihar SJ, Naveen DS, Agrawal NK

Pdf Page Numbers :- 147-154

Vihar S Joshi¹, Naveen DS^1,*, and Nilesh Kumar Agrawal¹

¹Department of Orthopedics, Jagadguru Jayadeva Murugarajendra Medical College (JJMMC), Davanagere, Karnataka-577004, India

*Corresponding author: Dr. Naveen DS, Assistant Professor, Department of Orthopedics, Jagadguru Jayadeva Murugarajendra Medical College (JJMMC), Davanagere, Karnataka-577004, India. Mobile: +919986091144; Email: nds5959@gmail.com

Received 17 March 2021; Revised 28 May 2021; Accepted 10 June 2021; Published 18 June 2021

Citation: Vihar SJ, Naveen DS, Agrawal NK. Selective extraforaminal nerve root block for management of lumbar radiculopathy. J Med Sci Res. 2021; 9(3):147-154. DOI: http://dx.doi.org/10.17727/JMSR.2021/9-21

Copyright: © 2021 Vihar SJ et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Lower back pain with radiculopathy is one of the common complaints that patient presents to an orthopaedician. Study was done to assess effect of extraforaminal Selective Nerve Root Block (SNRB) in management of lumbar radiculopathy in 50 patients between December 2019 and June 2020 at Bapuji Medical College and Chigateri General Hospital, Davanagere, Karnataka, India. Extraforaminal SNRB was performed and Visual Analogue Scale (VAS) scores recorded pre procedure, immediate post procedure, one month and 6 months post procedure. Significant decrease (p<0.001) in VAS scores immediate post procedure by 5 or more points in 25%; by 3-4 points in 44% and 1-2 points in 6% of the patients obtained. One month post procedure showed statistically significant results (p<0.005) owing to change in VAS score by 1-2 points in 84% (42) patients and no change or increase in the VAS scores only in 10%(5) patients. VAS scores at 6th month showed statistically significant results (p<0.005) with reduction of VAS scores in 46.34% (19), retention of VAS score 0 in 31.70% (13) and no change or increase in VAS scores in only 21.95% (9) patients. Our study concludes that extraforaminal SNRB acts as excellent diagnostic tool and therapeutic modality for immediate and long term pain management in lumbar radiculopathy. Increase in the pain scores at 6th month (p=0.2) shows that recurrence of symptoms is a possibility. Further randomized control studies with larger study population, association of patient factors affecting extraforaminal SNRB would give better insight and knowledge of the factual data.

Keywords: extraforaminal selective nerve root block; lumbar radiculopathy; lumbar intervertebral disc