| Effect of Transforaminal Dorsal Root Ganglion and Epidural Block in Herniated Lumbar Disc Disease: Results from Minimum of 6-Month Follow-up |
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Jung-Yul Park, M.D., Chang-In Lee, M.D., Sang-Dae Kim, M.D., Se-Hoon Kim, M.D. Dong-Jun Lim, M.D. and Jung-Keun Suh, M.D. |
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Department of Neurosurgery, College of Medicine, Korea University, Seoul, Korea |
| 요추간판탈출증에 대한 경추간공 후근신경절 및 경막외 신경차단술의 효과: 6개월 이상의 추적 결과 |
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박정율·이창인·김상대·김세훈·임동준·서중근 |
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고려대학교 의과대학 신경외과학교실 |
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| Abstract |
Objective
This study is aimed to determine and validate the therapeutic value and long-term effects of transforaminal dorsal root ganglion(DRG) andepidural block in patients with refractory back and radicular leg pain due to herniated lumbar disc disorders.
Methods
Patients who met our inclusion criteria received the fluoroscopy guided, transforaminal DRG and epidural blockstargeted directly at the level and side of their documented pathology. Patients were evaluated by an independent observer and received sequential questionnaires before and after injection to document level of pain, level of activity, and amount of satisfaction.
Results
Two hundred and fifty-four patients met our inclusion criteria and were followed for a minimum period of 6 months(average 35 weeks, range 24-50 weeks). Two hundred and twenty-one(87.0%) had a successful long-term outcome, reporting at least a 50% reduction between pre- and post-injection pain scores, and were able to return to or near to their previous levels of functioning after an average of 2.2 injections(range 1-3). Onlynine(3.5%) of the remaining 33 patients underwent an operation. Twenty-four patients showed recurrence of symptoms, but obtained beneficial effects, similar to earlier blocks, from subsequent injections. Of our patients, 85.0% were satisfied with their outcomes. There was no worsening of symptoms or complications from the procedures.
Conclusion
The fluoroscopy guided transforaminal DRG and epidural blocks appear to be an effective nonsurgical treatment option for patients with lumbar herniated nucleus pulposus and radiculopathy for whom conservative treatments are not effective, and should be considered before surgical intervention.
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| Keywords:
Vertebral foramen, Dorsal root ganglion, Herniated lumbar disc, Nerve block |
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