title: The Role of Selective Nerve Root Block in the Treatment of Lumbar Radicular Leg Pain.
abstract: The objective of this retrospective study was to investigate the clinical effectiveness of nerve root blocks (i.e., periradicular injection of Lidocaine and triamcinolone) for lumbar monoradiculopathy in patients with a mild neurological deficit in National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh from March 2014 to December 2014. We Included 24 patients (32-74 years) with a minor sensory/motor deficit and an unequivocal MRI finding (18 disc herniations, 6 foraminal stenosis) 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. Seventeen patients (87%) had rapid (1-4 days) and substantial regression of pain, four required a repeat injection. Sixty percent (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 6 months (2-9 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: Dr Sharif Ahmed Jonayed, Junior Consultant, National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh.
authors.forename: S A
authors.initials: SA
authors.lastname: Jonayed
authors.forename: M
authors.initials: M
authors.lastname: Kamruzzaman
authors.forename: M K
authors.initials: MK
authors.lastname: Saha
authors.forename: S
authors.initials: S
authors.lastname: Alam
authors.forename: S
authors.initials: S
authors.lastname: Akter
mesh_terms: D000328:Adult; D000368:Aged; D001459:Bangladesh; D003251:Constriction, Pathologic / Q000188:drug therapy; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D007866:Leg / Q000503:physiopathology; D008012:Lidocaine / Q000627:therapeutic use*; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008875:Middle Aged; D009407:Nerve Block; D059408:Pain Management; D011843:Radiculopathy; D012189:Retrospective Studies; D014221:Triamcinolone / Q000627:therapeutic use*
chemical_list: D014221:Triamcinolone; D008012:Lidocaine