Joon Woo Lee, Presenter: Nothing to Disclose

Sung Hyun Kim MD, Abstract Co-Author: Nothing to Disclose

Jung-Ah Choi MD, Abstract Co-Author: Nothing to Disclose

Heung Sik Kang, Abstract Co-Author: Nothing to Disclose

To relate different types of injection of selective nerve root block (SNRB) to short-term therapeutic effect for sciatica

SNRB was performed in 248 patients from June 2003 to May 2004. Fifty-six patients (33 women, 23 men; mean age, 53.3 years; age range, 30 –83 years) were included. The contrast material distributions of SNRBs were graded by three radiologists in consensus as intraepineural injection or extraepineural injection. The short-term therapeutic effect was evaluated 2 weeks after SNRB. The relationship between types of injection and short-term therapeutic effect were analyzed. Other possible outcome predictors such as saddle type (contrast materials distributions rostrally to the epidural portion of the preganglionic nerve root) or not, cause of sciatica (spinal stenosis vs herniated disc), age, sex and duration of sciatica (acute or subacute vs chronic) were also analyzed. Fisher exact test, chi-squire test and multiple logistic regression analysis were used for statistical analysis.

Forty-three patients showed effectiveness 2weeks after SNRB (78.8 %). With intraepineural injection, there was effectiveness in 19 of 29 ( 65.5 %); extraepineural, in 24 of 27(88.9%,). Extraepineural injection was significantly associated with better outcomes than intraepineural (p < 0.05). There were other possible better outcome predictors, however, not statistically significant; saddle type of contrast distribution, herniated disc, acute or subacute sciatica. Multiple regression analysis showed that the factor significantly associated with outcomes was only the type of injection (p = 0.04, Odds ratio: 5.01).

The therapeutic SNRB is an effective tool for the treatment of pain in patients with sciatica. Extraepineural injection showed significantly better outcome than intraepineural.

Lee, J, Kim, S, Choi, J, Kang, H, Therapeutic Effect of Selective Nerve Root Block for Sciatica: Intra- versus Extraepineural Injection.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4410821.html