The Neural Blockades for Low Back Pain and Radicular Pain in Patients

ABSTRACT

OBJECTIVE: The purpose of this study is to determine the efficacy of neural blockades in patients with herniated lumbar disc and lumbar spinal stenosis. METHODS: The authors reviewed 47 patients with low back and radicular pain, treated with epidural and facet block at the departments of anesthesiology and neurosurgery from June 2000 to November 2001. Epidural blockade was performed via transforaminal, translaminar, or transcaudal route. Facet blocks were performed at the corresponding levels, including above and below the reference level, in patients accompanied with facet syndrome. Improvement was evaluated with pre- and post-block visual analogue scale score and follow-up evaluation was performed at the time of first recurrence to the level of pre-block pain. Time to first recurrence was analyzed with Kaplan-Meyer Survival analysis according to disease entity. RESULTS: After one cycle of blockade, effective responses lasting more than 1 month were 64% more than 3 months were 48% of patients. Median time to first recurrence were 21 weeks in patients with herniated lumbar discs, 7 weeks with lumbar spinal stenosis. The former group showed significant pain improvement(p=0.048). CONCLUSION: Despite of relative short-term effect, neural blockade provides substantial pain relief in majority of patients and this lead early and efficient rehabilitation and exercise therapy.