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The following is a summary of “Clinical Outcomes of Percutaneous Transforaminal Endoscopic Discectomy Assisted with Selective Nerve Root Block for Treating Radicular Pain with Diagnostic Uncertainty in the Elderly,” published in the February 2024 issue of Pain by Zhu al.
Researchers conducted a retrospective study to evaluate the effectiveness of percutaneous transforaminal endoscopic discectomy combined with selective nerve root block in managing radicular pain with unclear diagnosis in elderly patients.
They enrolled 36 elderly patients in the study. Operative time, hospital stay time, Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and global outcome were accessed based on the Macnab outcome criteria before and after surgery.
The results showed 17 males and 19 females with a mean age of 73.72 ± 7.15. All patients presented with radicular pain lasting at least two months. Radiological findings indicated multilevel disc herniation in 80.6% of patients, prior lumbar fusion surgery in 16.7%, and degenerative scoliosis in 8.3%. Additionally, 69.4% of patients had at least one comorbidity. 85.4% responded positively to selective nerve root block, and 91.6% reported favorable outcomes at the last follow-up. Pre-operative leg pain mean value was 7.56 ± 0.74, significantly decreasing post-surgery (2.47 ± 0.81, P<0.001). ODI mean decreased from 43.03 ± 4.43 to 5.92 ± 5.24 (P<0.001) one year post-surgery.
Investigators concluded that nerve block-guided surgery resolved unclear radicular pain in the elderly, confirming the diagnosis and achieving positive outcomes for multilevel lumbar degeneration.
