Objectives: This study aimed to evaluate patients undergoing transforaminal nerve block treatment in lumbar disc herniation (LDH) and spinal canal stenosis. Methods: It is an observational descriptive cross-sectional study at a single tertiary care hospital. It is based on a review of electronic medical records of patients suffering from lower back pain from either LDH or spinal canal stenosis and who underwent transforaminal nerve blocks between January 2019 and December 2021. Results: A total of 440 patients were included in this study. Study findings reported that the etiology behind the treatment was mostly due to spinal canal stenosis with 223 cases (50.7%), followed by disc bulge with 208 cases (47.3%), two cases had both diagnoses, and the others had different etiologies such as degenerative disease with scoliosis, micro decompression. The visual analog scale pain score was highest on the pre-injection time point (7.1 ± 1.1) and decreased significantly with time after the injection to reach 2.7 ± 1.04 after 6 months. Similarly, the Oswestry Disability Index was high during pre-injection (64.9 ± 7.5) and decreased significantly to 19.3 ± 16.2 after 1-day post-injection and 13.2 ± 3.8 after 6 months. Conclusion: This study proves that transforaminal nerve block is an alternative treatment with proven efficacy and safety with quick pain relief in these patients, especially in the early phase, with immediate benefit.
Studies have shown that extramedullary intradural tumors (EIDTs) can develop from various tissues and structures surrounding the spinal cord, including nerve roots, meninges, or vertebral bodies. Nerve sheath tumors account for approximately 30% of EIDTs in adult, while meningeal tumors account for approximately 25%. The prevailing types of tumors are Schwannomas, accounting for 29% of cases, and gliomas at 22%. We present our 46-year-old female who visited the clinic reporting a persistent upper back pain in the thoracic region for one year. The MRI revealed an EIDT on the right side of the spinal canal at the T6-T7 level which was consistent with a possible diagnosis of schwannoma. This case report highlights the diagnosis, management, and outcome of a patient with schwannoma. Following removal of the extradural portion of the mass, the dura defect was closed by duraplasty. Fortunately, there was no observed loss of function after surgery. This favorable result underscores the critical role of timely and precise diagnosis, meticulous preoperative assessment, and appropriate surgical methods in managing such tumors. This case report on Schwannomas can contribute to our understanding of the disease and help in developing better treatment and management strategies compared to the literature which is still unclear.
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