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What types of degenerative lumbar pathologies respond to nerve root injection? A retrospective review of six hundred and forty one cases

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Abstract

Purpose

Peri-radicular injection is a widely used procedure for treating lumbar radicular pain, but it remains unclear what types of lumbar pathologies respond well to this treatment. We aimed to investigate the efficacy of peri-radicular injection for degenerative lumbar disorders and to determine what types of pathologies respond well to this treatment.

Methods

We reviewed the records of 641 consecutive patients who underwent peri-radicular injection for degenerative lumbar pathologies with mean follow-up of 23.4 months. The pathologies included herniated disc in 286 patients, spinal stenosis in 141, degenerative spondylolisthesis in 136, failed back surgery in 24, isthmic spondylolisthesis in 22, degenerative scoliosis in 18, and foraminal stenosis in 14. Outcome measure was whether or not surgery is avoided by using peri-radicular injection. The rate of obviating surgery was determined in each pathology.

Results

Peri-radicular injection obviated surgeries in 331 patients (51.7 %). There were no complications related to the procedure, including neurological deterioration, infection, and haematoma. The rate of obviating surgery was 42.0 % in disc herniation, 52.9 % in degenerative spondylolisthesis, 67.4 % in spinal stenosis, 54.5 % in isthmic spondylolisthesis, 57.1 % in foraminal stenosis, 61.1 % in degenerative scoliosis and 54.1 % in failed back surgery. Poor outcomes were observed in herniated disc with spinal stenosis (17.9 % success), foraminal disc herniation (33.3 %), recurrent disc herniation (18.2 %) and failed back surgery with instability (33.3 %).

Conclusions

This study demonstrated that 51.7 % of patients with degenerative lumbar pathologies were successfully treated by peri-radicular injection. Efficacy was limited in cases of herniated disc with spinal stenosis, foraminal disc herniation, recurrent disc herniation and failed back surgery with instability.

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Authors and Affiliations

  1. Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan

    Masahiro Kanayama, Fumihiro Oha & Tomoyuki Hashimoto

  2. Clinical Collaborative Department, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Masahiro Kanayama & Tomoyuki Hashimoto

Authors
  1. Masahiro Kanayama
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  2. Fumihiro Oha
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  3. Tomoyuki Hashimoto
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Correspondence to Masahiro Kanayama.

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Kanayama, M., Oha, F. & Hashimoto, T. What types of degenerative lumbar pathologies respond to nerve root injection? A retrospective review of six hundred and forty one cases. International Orthopaedics (SICOT) 39, 1379–1382 (2015). https://doi.org/10.1007/s00264-015-2761-3

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  • DOI: https://doi.org/10.1007/s00264-015-2761-3

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