The value of lumbar dorsal root ganglion blocks in predicting the response to decompressive surgery in patients with diagnostic doubt

Williams, Adam; Germon, Tim

doi:10.1016/j.spinee.2015.01.004

Cited by 11 publications

(19 citation statements)

References 19 publications

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“…>50%) was not documented in any patient within the here investigated group, further research is needed to investigate the effect of periradiucular injections in such patients. Although subject of further investigation, we suspect that the amount of T2-melting will also correlate with clinical outcomes of decompression as there seems to be an association of pain relief achieved with periradicular infiltration and surgical decompression [20].…”

Section: Discussionmentioning

confidence: 99%

Severity of foraminal lumbar stenosis and the relation to clinical symptoms and response to periradicular infiltration—introduction of the “melting sign”

2018

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Section: Discussionmentioning

confidence: 99%

Severity of foraminal lumbar stenosis and the relation to clinical symptoms and response to periradicular infiltration—introduction of the “melting sign”

2018

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“…To the best of our knowledge, this is the first study that compared SD treatment with NSD in DDPs. Although the sample size was small, our study used Good (50% -74%) 9 13…”

Section: Discussionmentioning

confidence: 99%

“…SNRB has been used reliably to predict the pain-generating nerve roots with a reporting accuracy of 31% to 100% (7,9,20,32). In clinical studies, a higher cutoff value may improve the diagnostic accuracy by increasing true-negatives and falsenegatives (20).…”

Section: Discussionmentioning

confidence: 99%

“…Current diagnosis of pain generation relies heavily on the patients' clinical symptoms, signs, or imaging findings (9,10). For DDPs, diagnosis of radiative pain may be complicated by confounding conditions, such as equivocal, multilevel, or extraforaminal pathology and nerve root anomalies, spinal inflammation, or compression of nerve roots (8,11).…”

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confidence: 99%

“…It is of paramount significance to precisely determine the location of the involved compressed nerve roots or pain generators preoperatively. In this respect, a selective nerve root block (SNRB) is increasingly reported to be capable of predicting the involved compressed nerve roots (9,(16)(17)(18)(19). However, the extent to which the SNRB procedure can guide the surgery and reduce perioperative parameters and postoperative complications needs to be further studied.…”

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confidence: 99%

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The Effectiveness and Safety of Selective Lumbar Decompression in Diagnostic Doubt Patients: A Retrospective Control Study

Zhong

Tang

et al. 2017

Pain Phys

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Background: Our previous study demonstrated that selective nerve root block (SNRB) can influence decision-making in lumbar surgery by guiding the selection of nerve roots targeted for decompression in diagnostic doubt patients (DDPs). However, further studies were needed to determine whether this selective decompression (SD) procedure would result in similar clinical outcomes and reduce the perioperative parameters and postoperative complications as compared to the non-selective decompression (NSD) procedure. Objective: The specific goal of this study is to compare clinical outcomes, perioperative parameters, and complications between SD and NSD procedures in DDPs. Study Design: A retrospective control study. Setting: Gaozhou People’s Hospital. Methods: From January 2009 to January 2011, 57 lumbar surgery patients with diagnostic doubt were retrospectively reviewed. Basic patient parameters, as well as perioperative and postoperative data were compared between the selective and non-selective decompression groups. Clinical outcomes were evaluated using the visual analog scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores, and JOA recovery rates. Results: Both groups showed significant improvement in VAS, ODI, and JOA scores between preoperative and postoperative measurements. The differences in VAS and ODI scores between groups were not significant at 3 and 60 months postoperatively (both P > 0.05). In addition, there was no significant difference in JOA recovery rate (P = 0.659) and survival rate (P = 0.586) during the 60 months following surgery. However, distinctly superior perioperative parameters (operation time and hospital stay, blood loss and drainage volume, laminectomy numbers, and fusion segment numbers) were observed in the SD group (P < 0.001 for each score). Moreover, the SD-treated group experienced significantly fewer adverse events postoperatively (P = 0.036). Limitations: The limitations of this study lie in the size of the study and selection of patients and in the fact that it was not feasible to include all cases of diagnostic doubt. Conclusions: On the basis of the 5-year follow-up data, we suggest that the SD procedure guided by SNRB is an effective and safe method for the surgical treatment of DDPs. This procedure produces superior perioperative parameters when compared with the conventional NSD procedure, but has a comparable clinical outcome. Moreover, the benefits of SD surgery include fewer perioperative and postoperative complications. Key words: Lumbar spinal surgery, diagnostic doubt, selective nerve root block (SNRB), selective decompression (SD)

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The value of contrast-enhanced three-dimensional isotropic T2-weighted turbo spin-echo SPACE sequence in the diagnosis of patients with lumbosacral nerve root compression

Kong

Sun

et al. 2020

Eur Spine J

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The value of lumbar dorsal root ganglion blocks in predicting the response to decompressive surgery in patients with diagnostic doubt

Cited by 11 publications

References 19 publications

Severity of foraminal lumbar stenosis and the relation to clinical symptoms and response to periradicular infiltration—introduction of the “melting sign”

Severity of foraminal lumbar stenosis and the relation to clinical symptoms and response to periradicular infiltration—introduction of the “melting sign”

The Effectiveness and Safety of Selective Lumbar Decompression in Diagnostic Doubt Patients: A Retrospective Control Study

The value of contrast-enhanced three-dimensional isotropic T2-weighted turbo spin-echo SPACE sequence in the diagnosis of patients with lumbosacral nerve root compression

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