Selective Spinal Nerve Root Block as an efficacious modality of treatment in lower backache with radiculopathy in cases of single level prolapsed intervertebral disc

Abstract

Background: Back pain affects everybody at some point in their life and is one of the most common complaints evaluated by a spine surgeon. Lower limb radiculopathy is commonly associated with conditions like disc herniation, facet or ligamentous hypertrophy, and spondylolisthesis. The present study was conducted to assess the prognosis after a single dose of Selective Spinal Nerve Root Block in patients with lower backache with radiculopathy with a single level disc prolapse. Methods:Forty patients with complaints of lower backache with lower limb radiculopathy with a single level Prolapse Intervertebral disc[Magnetic Resonance Imaging (MRI) diagnosed] were assessed on the basis of Visual Analogue Scale score and Roland Morris Questionnaire score at different time intervals pre and post single level spinal nerve root block to assess the reduction in pain. Results:Pain recurrence was noted in four (10%) patients at 3-month post block and total five patients at six months post block. Five (12.5%) patients underwent a surgical procedure after six months of a block. A significant (p<0.0001) reduction in the Roland Morris Questionnaire scores (Mean 19.53) and Visual Analogue Scale score for back pain (Mean 4.48) and leg pain (Mean 7.5) were observed during the follow-ups of Roland Morris Questionnaire scores at three months (Mean 2.55) and six months (Mean 3.55); with Visual Analogue Scale score at three months for back pain (Mean 1.60), leg pain (Mean 1.45) and six months for back pain (Mean 1.07) and leg pain (Mean 2.2) in 35 (87.5%) study subjects after block. Conclusion: The study recorded a pain-free period averaging six months with positive outcomes in almost all patients, indicating selective nerve root block efficacy among patients with lower back pain with radiculopathy with a single level prolapsed intervertebral disc, especially in younger patients and those with a short duration of symptoms.