Abstract
Objectives: To assess whether peri-radicular infiltration of corticosteroids has any effect on the need for subsequent interventions such as additional root blocks and/or surgery.
Study Design: A double blinded randomised controlled trial
Methods: 81 patients with unilateral radicular pain and failed conservative management were randomised to two groups (B and S). Group B received a single peri-radicular injection with bupivacaine and group S received bupivacaine and methylprednisolone. Both patient and surgeon were blinded to the method of treatment. Statistical analysis involved the use of a Chi Square test.
Outcome measures: 1. Number of additional root blocks required and 2. Requirement for surgery.
Results: At a median follow-up of 20 months (range 12–31 months) follow-up data was available for 70 patients (86%) with 35 patients in each group. There were an equal number of males and females in the groups. In group B, 10 patients required a further root block (29%) compared with 6 patients in group S (17%) [p=0.39]. Similarly 8 patients in group B required subsequent surgery (23%) compared with 3 in group S (9%) [p=0.19]. These differences did not achieve statistical significance probably due to the modest size of this study.
Conclusion: Our findings suggest that adding corticosteroid to bupivacaine nerve root blocks may reduce the need for further root blocks and surgery.
Correspondence should be addressed to SBPR c/o Royal college of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN
