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Asian J Pain > Volume 3(1); 2017 > Article
Asian Journal of Pain 2017;3(1):8-11.
DOI: https://doi.org/10.35353/ajp.3.1.8    Published online May 30, 2017.
Comparison of Spinal Nerve Root Block Alone and Spinal Nerve Root Block with Psoas Compartment Block in Patients with a Herniated Lumbar Disc
Sung Mo Ryu1, Seung-Kook Kim2, Eun-Sang Kim1, Soo-Chan Lee2
1Department of Neurosurgery Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Spine Center Himchan Hospital, Incheon, Korea
Correspondence:  Seung-Kook Kim, Tel: +82-1899-2220, Fax: +82-2-3410-0048, 
Email: deux8888@naver.com
Abstract
Objective
Spinal nerve root blocks (SNRBs) have been used to provide pain control for herniated lumbar discs (HLDs). Psoas compartment blocks (PCBs) have been used to provide pain control for lumbar sprain, and analgesia for post-operative pain. This block is advocated for relieving pain of various origins in the lower extremities and pelvic region. However, the efficacy of additional PCB is unknown. In this study, we compared conventional SNRB versus SNRB with PCB for HLDs.
Methods
Forty patients with HLD disease were randomly divided into two groups. Group A was administered dexamethasone (2 mL) with lidocaine (2 mL, 0.5%) into the transforaminal epidural space (L4-L5, L5-S1) in the prone position. Group B was administered lidocaine (10 mL, 0.5%) to the bilateral psoas compartment muscles (L3-L4, total: 20 cc) and was administered an SNRB using the same regimen as described above.
Results
Neither method failed in any of the patients in either group. Initial visual analogue scale (VAS) scores were decreased, although not statistically significantly, in group B as compared to group A. By 60 days post-operatively, VAS scores were decreased in both groups, but also not statistically significantly.
Conclusion
SNRB is a proven treatment for controlling inflammation in HLD patients. Use of PCB blocks may extend the initial pain control by providing muscular stabilization. However, SNRB with PCB was not more effective than conventional SNRB.
Key Words: Epidural space; Intervertebral disc displacement; Back pain
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