Sonography guided lumbar nerve and facet blocks: The first report of clinical outcome from Iran |
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| Institution: | 1. Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;2. Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;3. Division of Neurosurgery, Department of Surgery, Pastor Hospital, Bam University of Medical Sciences, Bam, Iran;1. Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy;2. Department of Radiology, General Hospital Sant’Andrea, La Spezia, Italy;3. Department of Orthopedic Surgery, General Hospital Sant’Andrea, La Spezia, Italy;4. Department of Pathology, General Hospital Sant’Andrea, La Spezia, Italy;1. British Columbia Cancer Agency, British Columbia, Canada;2. Foothills Medical Centre, Calgary, Alberta, Canada;3. School of Allied Health Professions, Canterbury Christ Church University, Kent, UK;4. Radiology Department, Homerton University Hospital, London, UK;5. Royal Brisbane and Women''s Hospital, QLD, Australia;6. Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada;7. Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada;8. School of Dentistry and Health Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia;9. Society and College of Radiographers, London, UK;10. School of Dentistry and Health Sciences, Charles Sturt University, Port Macquarie, NSW, Australia |
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| Abstract: | IntroductionNerve root block (NRB) and facet block (FB) are viable options for pain arising from facet and lumbar disc herniation (LDH) not responding to conservative therapy but still not suitable for surgery. Classically, they are performed under fluoroscopy and computed tomography (CT) guidance, which have the disadvantages of radiation exposure and limited accessibility. The aim of this study was to assess the effectiveness of US guided FB and NRB in patients suffering from facet arthropathy and LDH.Methods14 patients were involved in the study. After defining nerve root (for NRB) or facet joints (for FB) under a standard US investigation, real-time injection of methylprednisolone and bupivacaine was performed. Pain was measured before and after procedure by VAS.ResultsTen patients underwent FBs (8 bilateral and 2 unilateral) and 4 underwent NRBs (2 bilateral and 2 unilateral). 11/14 (79%) patients improved after the block (8 in FB, 3 in NRB) and the VAS had significantly decreased 1 week after procedure (mean range] −1.7 −6 to 0]). For the 11 patients that improved after FB or NRB, the effect lasted for a mean of 59 days (range: 30–130 days). Analysis showed that neither block procedure (NRB vs. FB) nor block level (L4L5 vs. L5S1) had an effect on result.ConclusionsResults of our preliminary study shows that in appropriately selected patients, nerve root and facet blocks can be effectively performed under ultrasonography guidance without notable complications, with effects lasting for a mean 2 months. |
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| Keywords: | Sonography Nerve root Facet Disc herniation Block |
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