Abstract: Introduction: Among chronic conditions, back problems are the most frequent cause of limitations of activity in persons less than 45 years of age. Sciatic neuralgia is a nerve root oedema because of the inflammatory, immunological, and mechanical factors. The lifetime prevalence of lumbar radiculopathy has been reported to be 5.3% in men and 3.7% in women. Steroid injections play an important role in the management of sciatic radiculopathy. Steroids act by reducing the oedema around the nerve roots and decreasing pain having the advantage of reduced dosage and targeted delivery around the nerve roots forming the basis of transforaminal nerve root block injections. In this study we want to study the effectiveness of transforaminal nerve root block in 30 patients post block and 3 months later.
Aims and objectives: Aims and objectives of the study are as follows:
1. To study the effectiveness in relief of symptoms in transforaminal nerve root block in lumbar disc disease.
Materials and Methods: The clinical and follow-up data of 30 patients having lumbar disc disease causing sciatic neuralgia were taken from May 2019 to December 2019 in MGM medical college and hospital Kamothe Navi Mumbai were retrospectively analysed in this study. Follow-up was conducted immediately after the administration of block, as well as 3 months post the administration of the root block. Preoperative VAS scoring and was done and same were repeated post block and at 3 months to observe the functional outcome of transforaminal root block.
Results: The average follow-up was 6 months. At 2 to 3 weeks’ follow-up, 28 of 30 patients reported successful pain reduction. In 25 patients, this pain reduction was obtained immediately and in a further 3 patients within 4 days. In 2 patients, the nerve root block did not show a sufficient pain reduction. In total with 6months of follow up 26 patients with pain relief after the first injection had a permanent and substantial pain reduction, 16 did not require surgery, 6 had disc herniation and the remaining 3 had foraminal stenosis for which operative procedures were planned.
Conclusion: From our study we can conclude that transforaminal Root block should be the first choice in treating and diagnosing patients with disc herniation. Root block is more effective in patients with disc herniation rather than canal stenosis. We also understand from our study that transforaminal Root block is more effective in early course of disease, within 6 weeks of onset of symptoms. So we conclude that larger discs should later be planned for an open or endoscopic decompression and mild and moderate disc can also be managed conservatively after a transforaminal root block. The patient’s clinical course remains the most important determinant for treatment decision in disc herniation.
