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Volume 12 Issue 2 ( April- June) 2023

Original Articles

Efficacy of selective nerve root block using bupivacaine with or without steroid in lumbar radicular pain: A randomised controlled study
Dr.SomashekaraSA, Dr. SomashekarD, Dr. Giridhar U

Low back pain is the most common presenting compliant to the orthopedic outpatient department across the world. Intervertebral disc herniation constitutes up to 6% of cases of low back pain. Herniated disc causes radicular pain, sensory disturbance, motor weakness, bowel/bladder disturbance in accordance with the level and severity of condition. Treatment options available include conservative management, local injections and surgical management. Appropriate treatment differs in each case considering Severity of pathology, clinical picture and patient profile. Young patients with mild to moderate Pathology and elderly patients who are not fit for surgical procedure benefit from Selective nerve root block, which relieves pain and provides opportunity for Patient to postpone surgery temporarily or permanently. Here we intend to determine the efficacy of Selective Lumbar nerve root block in herniated disc/neural foraminal stenosis in pain relief and improvement in disability. Adult patients of either sex admitted/visiting our hospital for low back pain due to herniated disc or neural foraminal stenosis during March 2020 to October 2022 were taken into study. A total of 60 patients were included in randomized study, 30 were treated with cocktail of (Bupivacaine + Triamcinolone) and the other 30 were treated with Bupivacaine alone. Patients were followed up for 3 months with serial neurological examination and functional outcome. Patients treated with Cocktail of Bupivacaine + Triamcinolone had more favorable scores of VAS and ODI which is statistically significant (p<0.04). Among Patients with IVDP and Neural foraminal stenosis, Patients with IVDP had better VAS score and ODI which was statistically significant. Improvement in Scores is better in patients who are not obese, with no sensory/motor involvement, which was statistically significant. Most of the patients treated with Cocktail returned to work/regular activities in 6 weeks. Conclusion: Patients with IVDP Treated with cocktail of Bupivacaine + Triamcinolone had pain relief and improvement in disability at the end of 12 weeks compared to control group.

 
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