Outcome of Lumbar Nerve Root Block in Patients with Sciatica and Lumbar Disc Prolapse

Abstract

A recent review (UK Health Technology Assessment programme 2013) reported that selective lumbar nerve root block (SLRB) may be effective and cost-effective in treatment strategies for lumbar radicular pain, although there are conflicting results from studies, possibly related to problems such as heterogeneous patient groups and confusion with back and radicular pain. Review of 842 patients with SLRB in our centre, produced 740 with acceptable data quality (28-day pain diaries with pre-injection VAS 0-10 scores plus post-treatment data). Mean pre-injection VAS was 6.4. Mean VAS was 4.5 at two days following injection. At 28 days, mean VAS was 5.1. Some patients had major reduction in VAS in the first 24 hours, but this did not predict improvement at 28 days. However, within this group, 10% of patients had VAS scores no higher than 2/10 from seven days onwards, suggesting there may be worthwhile outcomes for sub-groups of patients.