Use of CT-guided periradicular injection for the treatment of foraminal and extraforaminal disc herniations

Gruenberg, Marcelo; Petracchi, Matias; Valacco, Marcelo; Solá, Carlos

doi:10.1055/s-0030-1267109

Cited by 9 publications

(10 citation statements)

References 21 publications

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“…It is mainly indicated for the management of intractable nerve root pain in order to ameliorate pain using a less aggressive option than surgery. 4 Considering the main aim of the procedure, surgical decompression of the nerve root was conducted if nerve root injection failed in order to assess the efficacy of each of the pharmacological formulae. The global failure rate was 16%, similar to the results described in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…The global failure rate was 16%, similar to the results described in the literature. 4,5 Choosing the type of medication for selective nerve root block is controversial, and several alternatives are available. The use of local anesthetic and depot steroids has been suggested in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…It is mainly indicated for the management of intractable nerve root pain in order to ameliorate pain using a less aggressive option than surgery. 4…”

Section: Discussionmentioning

confidence: 99%

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Lumbar Selective Nerve Root Block: Comparative Study Using Two Pharmacological Formulae

Guyot

2017

Global Spine Journal

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Study Design:Retrospective cohort study.Objectives:The objective of the present study was to compare the effectiveness of 2 different pharmacological formulae in selective nerve root injections.Methods:We studied a series of 298 patients who received a selective nerve root injection and made a comparative study dividing them into 2 groups according to the drugs used. In group A, we used betamethasone 6 mg and lidocaine, while in group B, triamcinolone 60 mg and bupivacaine were used for the procedure. We evaluated the patients for a period of at least 8 months, assuming the need for surgical therapy as the failure of the procedure.Results:Both groups had 149 patients with similar etiological characteristics. Forty-seven patients (16%) required surgery to relieve pain with a similar distribution between groups (24 from group A and 23 from group B). Time between nerve root injection and surgery was 86.79 (14-360) days on average in group A and 75.76 (2-180) days in group B with no statistical difference (P = .67). Only one complication was documented, an anaphylactic shock in a patient in group B.Conclusions:Based on these results, we found no difference in the type of steroid or local anesthetic used for selective nerve root injections.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lumbar Selective Nerve Root Block: Comparative Study Using Two Pharmacological Formulae

Guyot

2017

Global Spine Journal

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“…This is in accordance to the published literature. Several clinical studies with sample sizes of 20 to 140 patients reported no major complications (Table 1) [1][2][3][4][5][6][7][8][9][10] . Grönemeyer et al reported on CT-guided lumbar nerve root infiltration in 228 patients, with each patient receiving four to 11 infiltrations.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the widespread use of CT-guided lumbar nerve root infiltrations surprisingly few literature reports have systematically examined the safety of this approach. The complication rate has been reported in research articles or is summarized in reviews only [1][2][3][4][5][6][7][8][9][10][11][12][13] . A systematic study examining the safety of CT-guided lumbar nerve root infiltrations is missing.…”

Section: Introductionmentioning

confidence: 99%

Safety of CT-Guided Lumbar Nerve Root Infiltrations Analysis of a Two-Year Period

Gossner

2014

Interv Neuroradiol

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Selective nerve root infiltrations are frequently performed in patients with lumbar radiculopathy. Computed tomography (CT) is now commonly used for image guidance. Despite the widespread use of CT-guided lumbar nerve root infiltrations few studies have systematically examined the safety of this approach. In a two-year period, 231 lumbar nerve root infiltrations were performed on in-patients and were retrospectively reviewed. No major complications like inflammation (especially spondylodiscitis), large haematomas requiring surgery, severe allergic reactions or spinal ischaemia occurred. In accordance with other published studies, CT-guided lumbar nerve root infiltrations seem to be safe. To minimize the risk of catastrophic neurological complications due to spinal ischaemia, careful needle placement dorsal to the nerve root and the use of a non-particulate corticosteroid, like dexamethasone, are advocated.

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Mechanical low back pain—a rheumatologist's view

Borenstein

2013

Nat Rev Rheumatol

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Low back pain, in its acute and chronic forms, is one of the most common health problems and is frequently evaluated by rheumatologists. The multiple possible diagnoses associated with this symptom make correctly attributing back pain to a specific disease difficult. This dilemma necessitates an organized approach to separate patients with mechanical disorders from those with rare systemic disorders. The most common forms of back pain are mechanical. Gradual modifications in the axial skeletal structures over time result in pathological disorders that generally occur later in an individual's lifespan. The diagnostic process that identifies these mechanical disorders is straightforward and does not require expensive radiological or laboratory tests in the early phases of the evaluation. Most low back pain resolves without intervention, but some reports suggest that episodes of back pain are persistent or recurring for a substantial minority of patients. Therapies for back pain can be nonpharmacological, pharmacological or surgical. All interventions have limited capacity to resolve low back pain. Nonsurgical therapies are preferred for muscle injuries and osteoarthritis of the lumbar spine. Surgical interventions can resolve the pain and dysfunction of disc herniation and spinal stenosis more rapidly than conventional therapy, but surgical benefit wanes over time.

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Use of CT-guided periradicular injection for the treatment of foraminal and extraforaminal disc herniations

Cited by 9 publications

References 21 publications

Lumbar Selective Nerve Root Block: Comparative Study Using Two Pharmacological Formulae

Lumbar Selective Nerve Root Block: Comparative Study Using Two Pharmacological Formulae

Safety of CT-Guided Lumbar Nerve Root Infiltrations Analysis of a Two-Year Period

Mechanical low back pain—a rheumatologist's view

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