“EFFICACY OF NERVE ROOT BLOCK FOR THE TREATMENT OF LUMBAR SPINAL CANAL STENOSIS IN ADULTS OLDER THAN 60 YEARS OF AGE”

Abstract

Background:- Patients suffering from Lumbar spinal canal stenosis usually complain severe low back pain with Radiculopathy that warrants immediate treatment. Decompression of the Lumbar spine for stenosis is a classical procedure that amiably responds by relieving the patient from the neurogenic claudication and radiculopathy. Patients suffering from lumbar spinal canal stenosis usually prefer conservative management due to diminished function and other associated comorbidities. Selective nerve root block or Transforaminal epidural injection for lumbar spinal canal stenosis is a well-known conservative treatment since a long time but only a handful of the cases conrm its effectiveness in the elderly patients. Our investigation was carried out to nd the efcacy of Selective nerve root block for lumbar spinal canal stenosis in elderly patients above age of 60 years. The research is prospective study been conducted from August 2020 to July 2022 a Methodology:- t the Orthopaedics Unit, Maheshwara Medical College & Hospital, Chitkul, Patancheru, Telangana state. A total of 60 patients of both genders aged over 60 years with medicationresistant lumbar spinal canal stenosis without cauda equina syndrome were included in the study. Patients with acute lumbar disc herniation were excluded. We investigated the effectiveness of selective nerve root block, number of procedures, MRI ndings and duration of disease. Depending on duration & severity of disease, we performed 1 to 7 selective nerve root blocks by same spine surgeon. Patients who responded well are termed as effective group and Patients whose symptoms were not relieved by selective nerve root block and went for surgery were named as ineffective group. Out of total 60 patients, there were 22 (36.6%) male and 38 (63.3%) Female patients Results:- in the study group with a male to female ratio of 1:7. 35 patients were satised with selective nerve root block documented by reduction in pain in Visual Analogue Scale. In our study the effectiveness of selective nerve root block was 58%. The cross-sectional area of lumbar canal stenosis in the effective group was 108.63 mm2 whereas ineffective group had 77 mm2. This shows statistically signicant narrower area of lumbar canal in ineffective group with P value of 0.001. Our patients didn't have severe neuralgia after selective nerve root block. Our Discussion: - study outcome revealed that more than 58% of elderly patients with lumbar spinal canal stenosis showed symptomatic relief with selective nerve root block. Selective nerve root block can be performed in a safer way in the elderly and is likely to be a preferable treatment option for older patients with various risks like poor general condition. Conclusions:- Transforaminal epidural injection or Selective nerve root block can be tried in multiple settings which provides symptomatic improvement in elderly patients above 60 years of age and may be an option for conservative treatment.