title: An evaluation of the effectiveness of hyaluronidase in the selective nerve root block of radiculopathy: a double blind, controlled clinical trial.
abstract: METHODS
  Prospective, double-blind, randomized controlled trial.
  
  
  OBJECTIVE
  To determine the ability of hyaluronidase to provide longer lasting pain relief and functional improvement in patients with lumbar radiculopathy.
  
  
  BACKGROUND
  Selective nerve root block (SNRB) is a good treatment option in lumbar radiculopathy. We studied the effectiveness of hyaluronidase when added to the traditional SNRB regimen.
  
  
  METHODS
  A sample size of 126 patients per group was necessary. A sample of 252 patients who underwent an injection procedure with or without hyaluronidase due to radiculopathy was included in this study. The patients were randomly divided into two groups: the control (C) group and the hyaluronidase (H) group. After SNRB due to radiculopathy, the visual analog scale (VAS) was compared at 2, 4, 6, 8, and 12 weeks between the two groups, and the Oswestry disability index (ODI) was compared at 12 weeks between the two groups.
  
  
  RESULTS
  Both groups seemed to have general improvement in VAS, but in C group, the VAS was higher than the H group 2 and 4 weeks after the surgery, and the difference in time-group change between 2 groups was statistically significant (p <0.05). ODI improved in both groups, and the difference in time-group change between 2 groups was not statistically significant (p >0.05).
  
  
  CONCLUSIONS
  The rebound pain (the re-occurrence of pain within 2-4 weeks after injection) that occurs within 2-4 weeks after the injection of the routine regimen can be reduced when hyaluronidase is added to the routine SNRB regimen.
authors.affiliation: Department of Orthopaedic Surgery, Daegu Catholic University Medical College, Daegu, Korea.
authors.forename: Sang-Bong
authors.initials: SB
authors.lastname: Ko
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.affiliation: Department of Orthopaedic Surgery, Daegu Catholic University Medical College, Daegu, Korea.
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Chang
authors.affiliation: Department of Orthopaedic Surgery, Daegu Catholic University Medical College, Daegu, Korea.
authors.forename: Dong-Young
authors.initials: DY
authors.lastname: Shin
keywords: Hyaluronidase; Nerve block; Visual analog scale