Clinical parameters predicting successful outcomes following transforaminal epidural selective nerve root blocks for acute lumbar disc herniation

Abstract

Background: The lifetime prevalence of radiculopathy due to a herniated lumbar disc is estimated to be around 4% in females and 5% in males. The efficacy of SNRB in acute LDH has been quoted variedly in previous studies ranging from 30% to 80% [6]. There are only a few studies which identify the various clinical parameters that can predict successful outcomes in patients undergoing SNRB. Methods: The prospective study was conducted at Mahatma Gandhi Missions Hospital Navi Mumbai, between March 2019 and February 2020.During the study period, total 60 patients with documented LDH on magnetic resonance imaging (MRI), presenting with unilateral radiculopathy, with symptom duration of less than 3 months who had failed adequate conservative management of about 3 weeks duration were treated with transforaminal. Result: Out of the 60 patients which were included in the study, 50 patients had adequate pain relief for the study period of one year while 10 patients did not have sufficient relief of pain. Thus Transforaminal SNRB had an efficacy of 83.33% in our study. In our study out of the 60 patients 32 had right side involvement and 28 had left side involvement. Out of those having right side involvement 26 had successful and 6 had unsuccessful outcome while 28 had left side involvement in which 25 had successful outcome and 3 had unsuccessful outcome and the p value was insignificant for this clinical parameter. Conclusion: Transforaminal Selective Nerve Root Block had an efficacy of 83.33% in our study. It is an efficient technique which provides adequate pain relief for about one year.