J Korean Orthop Assoc.  2016 Feb;51(1):61-68. 10.4055/jkoa.2016.51.1.61.

Effectiveness of Selective Nerve Root Block on the Need for Surgical Treatment of Patients with Cervical Radicular Pain: A Minimum 5 Years Follow-Up

Affiliations
  • 1Department of Orthopaedic Surgery, Wonkwang University Hospital and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
  • 2Department of Orthopaedic Surgery, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea. niceo@daum.net

Abstract

PURPOSE
The purpose of this study is to assess the 5-year outcome of patients considering surgery for complaint of cervical and radiating pain treated by selective nerve root block (SNRB).
MATERIALS AND METHODS
Between January 2001 and December 2007, 39 cases were selected from patients who underwent SNRB before the operation and were followed-up for more than five years. The mean follow-up period was 64.3 months and the mean age was 57.7 years. The patients were divided into the operation group and the only cervical SNRB group. The groups were compared for gender, age, duration, disease, single or multi-level, and root compression rate on magnetic resonance imaging. The clinical results were analyzed using the neck disability index (NDI) and the visual analogue scale (VAS) score.
RESULTS
Among the 39 cases scheduled for the operation, 20 cases (51.3%) did not proceed to the operation and 13 cases among them were treated with additional conservative treatment. The average VAS score for the operation group and the cervical SNRB group was 8.1 points and 7.5 points at the preoperative state and the pre-injection state. After surgical treatment and cervical nerve root block, the scores were 3.0 points for all. The NDI for the operation group was 11.3 points at the last follow-up. The NDI for the cervical nerve root block group was 13.6 at the last follow-up. There was no significant difference between the two groups. Shorter duration and younger age tended to show a higher operation rate. At the last follow-up, 7 cases (17.9%) after cervical SNRB had persistent symptom relief without other treatment.
CONCLUSION
Cervical SNRB is considered an effective treatment for patients with cervical disease with radiating pain and who are scheduled for an operation.

Keyword

cervical radiculopathy; epidural injections; cervical pain
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