The Journal of Practical Medicine ›› 2023, Vol. 39 ›› Issue (14): 1804-18008.doi: 10.3969/j.issn.1006⁃5725.2023.14.013

• Clinical Research • Previous Articles     Next Articles

Clinical effect of intervertebral disc nerve block on lumbar disc herniation 

LIN Qiushui*,WU Xiaodong, WANG Jianxi,ZANG Fazhi,CHEN Huajiang.    

  1. Department of Spine Surgery,the First Affiliate Hospital,Navy Medical University,Shanghai 200433,China 
  • Online:2023-07-25 Published:2023-07-25
  • Contact: CHEN Huajiang E⁃mail:spine.chen@163.com

Abstract:

Objective To investigate the therapeutic efficacy of intervertebral disc nerve block in the treat⁃ ment of lumbar disc herniation. Methods The clinical data of 107 patients with lumbar disc herniation treated with nerve block between September 2015 and August 2017 were reviewed retrospectively. Among them,56 under⁃ going intervertebral disc injection with the guidance of fluoroscopy were assigned as IDI group and the other 51 cases undergoing transforaminal epidural injection with the guidance of fluoroscopy as TEI group. The compound of beta⁃ methasone + lidocaine was injected into the intervertebral discs in the IDI group,and into the transforaminal epidural spaces in the TEI group as well. Visual analogue scale(VAS)and Oswestry dysfunction index(ODI)assessments were performed before treatment,immediately after treatment and 3 months after treatment. MacNab scoring was performed at 3 months follow ⁃up after treatment. Results All patients′ symptoms were improved after treatment. The scores by VAS scores and ODI immediately and 3 months after treatment were significantly lower than those before treatment(P < 0.05)both in IDI group and TEI group,but the scores were not significantly different between the two groups(P > 0.05). According to the MacNab efficacy evaluation criteria,the total effectiveness rate was 100% in IDI group and 96% in TEI group,and the rate of being excellent and good was 75% in IDI group and 71% in TEI group. One patient in IDI group was complicated with infection after treatment and got healed after oral antibiotics and rest treatment. Conclusions Intervertebral disc nerve block is an effective treatment for lumbar disc herniation. It can be used as a supplement of conservative treatment methods. It is a traumatic manipulation which could lead to infection of intervertebral disc,accelerated disc degeneration and other serious complications, so surgeons should be cautious when deciding to adopt this approach.

Key words: disc herniation, lumbar intervertebral degeneration, intervertebral disc, nerve block ,