Analysis of SNRB in patients with lumbar radiculopathy resistant to conservative treatment.

ABSTRACT

Background: The transforaminal application performed with SNRB (Selective nerve root blocks) should be more accurate. Moreover, the amount of corticosteroid and local anesthetic can be reduced compared to the amount of these agents administered with the epidural steroid. Methods: Prospective study of 72 patients with low back pain done in Sri Ramachandra medical centre, Chennai during April 2012 to April 2014. 46 patients were diagnosed to have inter vertebral disc and 26 patients with Lumbar canal stenosis. The patients were evaluated using VAS score and Oswestry disability index. The indication and determination of the therapeutic SNRB level was established by the spine surgeon after all the diagnostic test results had been obtained and after a detailed discussion with the patient. After confirming the correct placement of spinal needle with a short bevel with the help of contrast, a solution of 1ml of 0.5% sensorcaine with 1 ml of triamcinolone acetonide (Inj. kenocort) is injected. Results: Only 2 patients out of 72 had persistent pain and underwent surgery. 60 of our patients were comfortable and were able to proceed with their normal life/day to day activities following the administration of one block. Conclusion: Selective nerve root block is effective and less invasive intervention, and serves as an adjunct to non-operative treatment. The blocks give the best result in disc herniation cases, followed by favorable results in foraminal stenosis.