Efficacy of Corticosteroid Addition to Selective Nerve Root Block for Lumbar Radiculopathy: A Multicenter Prospective...

Area of Science:

• Pain Management
• Neurology
• Orthopedics

Background:

• Selective Nerve Root Block (SNRB) with local anesthetic is common for lumbar radiculopathy.
• Evidence for adding corticosteroids to SNRB for functional outcomes is limited.
• This study investigates the efficacy of corticosteroid-enhanced SNRB.

Purpose of the Study:

• To evaluate if adding corticosteroids to SNRB improves functional disability and quality of life in lumbar radiculopathy patients.
• To compare outcomes between SNRB with corticosteroids and SNRB with local anesthetic alone.
• To assess pain reduction and functional improvement at 90 and 180 days post-procedure.

Main Methods:

• A multicenter, prospective cohort study of 78 patients with single-level lumbar radiculopathy.
• Patients received fluoroscopy-guided SNRB with corticosteroids (dexamethasone, betamethasone) plus lidocaine or lidocaine alone.
• Primary outcome: Oswestry Disability Index (ODI); Secondary outcomes: VAS leg pain, JOABPEQ, MCID achievement rates.

Main Results:

• The corticosteroid group showed significantly greater ODI improvement at 90 and 180 days (p<0.05).
• Significant improvements in leg pain (VAS) and JOABPEQ scores favored the corticosteroid group.
• Higher MCID achievement rates were observed in the steroid group at 90 days (75.0% vs 33.3%).

Conclusions:

• Corticosteroid addition to SNRB significantly alleviates functional disability and pain in lumbar radiculopathy.
• The most pronounced benefits were observed at 90 days and sustained through 180 days.
• The 90-day mark is optimal for assessing treatment success and guiding further management decisions.