J Korean Soc Spine Surg.  2014 Mar;21(1):8-14. 10.4184/jkss.2014.21.1.8.

Management of Patients with L2 Spinal Nerve Root Block Who Are Suffering from Low Back and Referred Pain

• Ahn DK
• Lee S
• Kim TW
• Hong SW
• Jung WS

• KMID: 1840411
• DOI: http://doi.org/10.4184/jkss.2014.21.1.8

Abstract

STUDY DESIGN: Prospective clinical study.
OBJECTIVES
The aim of the study was to verify the effectiveness of L2 spinal nerve root block for patients who are suffering from low back pain and referred pain with compound causes. SUMMARY OF LITERATURE REVIEW: Most of low back pain and referred pain arises from discs, facet joints and sacroiliac joints. All structures above have the pain perception pathway through sympathetic nerves with a connection to L2 spinal nerves.
MATERIALS AND METHODS
We selected patients with low back pain and referred pain for more than 2 weeks. Each 50 patients were randomly allocated to an experimental and a control group.The experimental group underwent a L2 spinal nerve root block with 2cc of 0.25% bupibacaine at the symptom dominant side. The control group underwent a skin infiltration with 2cc of 2% lidocaine only. The pain was assessed with a visual analogue scale (VAS) consisting of 100 points at 5minutes, day 1, day 3, day 5, day 7 and day 30 postprocedure.
RESULTS
Both groups showed a significant improvement after the procedures(p=0.000). However, a greater improvement was shown in the experimental group(p=0.000). In the individual analysis, the experimental group had improved as time elapsed and the significancewas maintained until 30 days. However, in control group, the significance was lost at day 30.
CONCLUSION
L2 spinal nerve root block is recognized to reduce the low back and referred pains which arise from compound causes in a degenerative spinal disease.

Keyword

L2 spinal nerve root block; low back pain and referred pain; intervertebral disc; facet joint; sacroiliac joint

MeSH Terms

Humans
Intervertebral Disc
Lidocaine
Low Back Pain
Pain Perception
Pain, Referred*
Prospective Studies
Sacroiliac Joint
Skin
Spinal Diseases
Spinal Nerve Roots*
Spinal Nerves*
Zygapophyseal Joint
Lidocaine

Figure

• 

  Fig. 1. A diagram of conspectus which shows number of initial selected cases, drop out cases final included cases.

• 

  Fig. 2. A graph which shows serial clinical improvement according to the elapsed time.

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