title: Therapeutic efficacy of selective nerve root blocks in the treatment of lumbar radicular leg pain.
abstract: The objective of this study was to investigate the clinical effectiveness of nerve root blocks (i.e., periradicular injection of bupivacaine and triamcinolone) for lumbar monoradiculopathy in patients with a mild neurological deficit. We have retrospectively analysed 30 patients (29-82 years) with a minor sensory/motor deficit and an unequivocal MRI finding (20 disc herniations, 10 foraminal stenoses) treated with a selective nerve root block. Based on the clinical and imaging findings, surgery (decompression of the nerve root) was justifiable in all cases. Twenty-six patients (87%) had rapid (1-4 days) and substantial regression of pain, five required a repeat injection. 60% of the patients with disc herniation or foraminal stenosis had permanent resolution of pain, so that an operation was avoided over an average of 16 months (6-23 months) follow-up. Nerve root blocks are very effective in the non-operative treatment of minor monoradiculopathy and should be recommended as the initial treatment of choice for this condition.
authors.affiliation: Spinal Surgery, Orthopaedic University Hospital Balgrist, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Narozny
authors.forename: M
authors.initials: M
authors.lastname: Zanetti
authors.forename: N
authors.initials: N
authors.lastname: Boos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002045:Bupivacaine; D005260:Female; D006801:Humans; D007267:Injections; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D009460:Neurologic Examination; D011843:Radiculopathy / Q000188:drug therapy*; D012189:Retrospective Studies; D013126:Spinal Nerve Roots / Q000187:drug effects*; D013130:Spinal Stenosis / Q000150:complications / Q000175:diagnosis; D014221:Triamcinolone
chemical_list: D014221:Triamcinolone; D002045:Bupivacaine