Abstract: Objective of this study was to assess the adequacy of relief provided by Nerve Root Block for Lumbar Radicular pain. If successful, this treatment can obviate the need for surgery considering the favourable natural history of this pathology.

We studied 64 patients who had this injection, from February 2000 to July 2001. These patients had clinical and radiographic confirmation of nerve root compression and were followed up at 2 and 6 weeks post injection and then at an average of 10 months by a questionnaire, which addressed patient satisfaction with injection treatment and pre-injection and present Low Back Outcome Score and Pain intensity on Visual Analogue Scale.

Overall, out of 64 patients injected, at 10 months follow-up, 50% (n=32) were satisfied with the treatment, 42% (n=27) injections failed and 8% (n=5) had incomplete follow-up. Pain intensity as measured on Visual Analogue Scale decreased from pre-injection mean value of 9.1 to post injection value of 4.9 the difference being statistically significant (p< 0.01). The Low Back Outcome Score increased from mean of 43 to 61, again the difference being statistically significant (p< 0.01).

Nerve Root Block is an effective therapeutic tool for Lumbar Radicular pain and should be recommended as the initial treatment of choice for this condition since it can provide persistent relief to the point that the patient does not require surgery.

A five-day-old boy was referred with a soft-tissue mass in his right upper arm. Plain radiographs and ultrasound demonstrated a lesion extending from the axilla to the elbow on the posterolateral aspect of the humerus. Open biopsy confirmed the diagnosis of congenital haemangiopericytoma. After MRI and selective angiography, excision biopsy was carried out, but no adjuvant therapy was administered. At further examination, four years and ten months later, he was noted to have three small nodules at the site of the original tumour. Excision biopsy confirmed this to be a local recurrence, although the lesion was less cellular with no appreciable mitotic activity. Congenital haemangiopericytoma is a rare cause of a soft-tissue mass in children. Most tumours are benign, and recurrence is uncommon. The treatment is controversial, but most centres recommend the use of adjuvant chemotherapy, combined with complete excision. We recommend treatment with doxorubicin. Orthopaedic surgeons should be familiar with this tumour since 30% to 50% of cases occur in the limbs.