selective nerve root block
Recently Published Documents


TOTAL DOCUMENTS

114
(FIVE YEARS 33)

H-INDEX

11
(FIVE YEARS 2)

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e052703
Author(s):  
Ingrid Schuttert ◽  
Hans Timmerman ◽  
Gerbrand J Groen ◽  
Kristian Kjær Petersen ◽  
Lars Arendt-Nielsen ◽  
...  

IntroductionPatients with chronic low back pain radiating to the leg (CLBPr) are sometimes referred to a specialised pain clinic for a precise diagnosis based, for example, on a diagnostic selective nerve root block. Possible interventions are therapeutic selective nerve root block or pulsed radiofrequency. Central pain sensitisation is not directly assessable in humans and therefore the term ‘human assumed central sensitisation’ (HACS) is proposed. The possible existence and degree of sensitisation associated with pain mechanisms assumed present in the human central nervous system, its role in the chronification of pain and its interaction with diagnostic and therapeutic interventions are largely unknown in patients with CLBPr. The aim of quantitative sensory testing (QST) is to estimate quantitatively the presence of HACS and accumulating evidence suggest that a subset of patients with CLBPr have facilitated responses to a range of QST tests.The aims of this study are to identify HACS in patients with CLBPr, to determine associations with the effect of selective nerve root blocks and compare outcomes of HACS in patients to healthy volunteers.Methods and analysisA prospective observational study including 50 patients with CLBPr. Measurements are performed before diagnostic and therapeutic nerve root block interventions and at 4 weeks follow-up. Data from patients will be compared with those of 50 sex-matched and age-matched healthy volunteers. The primary study parameters are the outcomes of QST and the Central Sensitisation Inventory. Statistical analyses to be performed will be analysis of variance.Ethics and disseminationThe Medical Research Ethics Committee of the University Medical Center Groningen, Groningen, the Netherlands, approved this study (dossier NL60439.042.17). The results will be disseminated via publications in peer-reviewed journals and at conferences.Trial registration numberNTR NL6765.


2021 ◽  
pp. 25
Author(s):  
Vikas Singh

Introduction: PIVD is the most common cause of lower back pain in old age. The most common site is L4 L5 to L5 S1 in about 95% cases, and about 90% cases are associated with radiculopathy. Methodology: This prospective study was conducted on 150 patients at the Jawahar Lal Nehru Hospital and Research Center between 2019 and 2021. We used 2–3 ml xylocaine and methylprednisolone. Results were assessed through clinical examination. Result: Of the 150 patients, 130 experienced excellent results with no pain for more than six months. Conclusion: We conclude that for mild cases, patients with PIVD have an alternative option of selective nerve root block other than surgery.


2021 ◽  
Vol 4 (5) ◽  
pp. 24
Author(s):  
Gabriel Calle ◽  
Lucio Huayhua ◽  
Alexis Martinez

The results obtained from a group of patients suffering from discoradicular conflict syndrome treated with paravertebral oxygen-ozone injections were analyzed. From a total number of 8500 patients treated with ozone during the period 2002/2015, 880 patients underwent intradiscal injection and 7620 patients were treated with paravertebral ozone injections. This paper analyses a subgroup of 1850 patients (24.28% of the patients who were treated with paravertebral injections), including those patients who underwent the total 10-session treatment, complied with a 5-year follow-up and with the sample homogeneity parameters following a predictability therapeutic effectiveness (PET) index devised for such purpose (PET index O3) by us in 2009. The outcomes were assessed based on the VAS score and modified Mac Nab criteria. Definite results determined positive post-treatment outcomes considered excellent and good in 81% of the cases. Such effectiveness percentage resulted lower than the one achieved with the intradiscal injection technique (89%), and higher than the percentage seen in papers on the selective nerve root block technique.


2021 ◽  
Vol 9 (3) ◽  
pp. 147-154
Author(s):  
Vihar SJ ◽  
Naveen DS ◽  
Agrawal NK

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.


2021 ◽  
pp. E483-E492

BACKGROUND: Selective nerve root block (SNRB) has been used to facilitate the diagnostic process when radiologic abnormalities are not correlated with clinical symptomatology in patients with cervical radiculopathy. Meanwhile, minimally invasive posterior percutaneous endoscopic cervical foraminotomy and discectomy (PPECFD) has been widely used to treat cervical radiculopathy because of its advantages. However, combination of these 2 procedures in the treatment of cervical radiculopathy with diagnostic uncertainty has not been reported. OBJECTIVES: To examine the clinical outcomes of PPECFD assisted with SNRB in patients who had cervical radiculopathy with diagnostic uncertainty. STUDY DESIGN: A retrospective design was used. SETTING: This study was conducted in a university-affiliated tertiary hospital in Shanghai, China. METHODS: Thirty consecutive patients with cervical radicular pain who had diagnostic uncertainty were included (January 2018 to January 2019). Diagnostic SNRB was performed to identify the responsible nerve root(s). PPECFD was selected as the treatment when the SNRB result was positive. Clinical outcomes were assessed by the Visual Analog Scale (VAS), Neck Disability Index (NDI), and modified Macnab criteria. Pre- and post-operative radiologic and clinical parameters were evaluated. Other information was retrieved from the electronic records. RESULTS: All patients had successful SNRB procedures. Four were excluded from the analysis because of the negative results of the SNRB. Among the remaining 26 patients who underwent the subsequent PPECFD surgery, the mean follow-up was 14 months. Compared with preoperative values, the mean VAS scores for radicular arm pain and neck pain, as well as the NDI score, improved significantly. According to the Macnab criteria, 22 patients (84.6%) had excellent or good results. No major peri- and postoperative complications were observed. LIMITATIONS: This study used a retrospective design with relatively small sample size and medium follow-up duration. CONCLUSIONS: Diagnostic SNRB may be a helpful tool to identify the origin of cervical radicular pain for patients with diagnostic uncertainty. With the guidance of SNRB, PPECFD is likely to be an effective and safe option for the treatment of cervical radiculopathy with diagnostic uncertainty. KEY WORDS: Cervical radiculopathy, selective nerve root block, percutaneous endoscopic cervical foraminotomy and discectomy, diagnostic, uncertainty


Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 635
Author(s):  
Seok Kang ◽  
Ha-Mok Jeong ◽  
Beom-Suk Kim ◽  
Joon-Shik Yoon

Background and Objectives: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. Materials and Methods: This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. Results: The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm2 (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. Conclusion: Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN.


Sign in / Sign up

Export Citation Format

Share Document