title: What types of degenerative lumbar pathologies respond to nerve root injection? A retrospective review of six hundred and forty one cases.
abstract: OBJECTIVE
  Peri-radicular injection is a widely used procedure for treating lumbar radicular pain, but it remains unclear what types of lumbar pathologies respond well to this treatment. We aimed to investigate the efficacy of peri-radicular injection for degenerative lumbar disorders and to determine what types of pathologies respond well to this treatment.
  
  
  METHODS
  We reviewed the records of 641 consecutive patients who underwent peri-radicular injection for degenerative lumbar pathologies with mean follow-up of 23.4 months. The pathologies included herniated disc in 286 patients, spinal stenosis in 141, degenerative spondylolisthesis in 136, failed back surgery in 24, isthmic spondylolisthesis in 22, degenerative scoliosis in 18, and foraminal stenosis in 14. Outcome measure was whether or not surgery is avoided by using peri-radicular injection. The rate of obviating surgery was determined in each pathology.
  
  
  RESULTS
  Peri-radicular injection obviated surgeries in 331 patients (51.7%). There were no complications related to the procedure, including neurological deterioration, infection, and haematoma. The rate of obviating surgery was 42.0% in disc herniation, 52.9% in degenerative spondylolisthesis, 67.4% in spinal stenosis, 54.5% in isthmic spondylolisthesis, 57.1% in foraminal stenosis, 61.1% in degenerative scoliosis and 54.1% in failed back surgery. Poor outcomes were observed in herniated disc with spinal stenosis (17.9% success), foraminal disc herniation (33.3%), recurrent disc herniation (18.2%) and failed back surgery with instability (33.3%).
  
  
  CONCLUSIONS
  This study demonstrated that 51.7% of patients with degenerative lumbar pathologies were successfully treated by peri-radicular injection. Efficacy was limited in cases of herniated disc with spinal stenosis, foraminal disc herniation, recurrent disc herniation and failed back surgery with instability.
authors: Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan, mkanayama@aol.com.
authors: Masahiro
authors: M
authors: Kanayama
authors: Fumihiro
authors: F
authors: Oha
authors: Tomoyuki
authors: T
authors: Hashimoto
mesh_terms: D000328:Adult; D000368:Aged; D055111:Failed Back Surgery Syndrome / Q000188:drug therapy; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007405:Intervertebral Disc Displacement / Q000188:drug therapy; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000188:drug therapy*; D013126:Spinal Nerve Roots; D013130:Spinal Stenosis / Q000188:drug therapy; D013168:Spondylolisthesis / Q000188:drug therapy