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Randomised controlled trial comparing the efficacy of ultrasound along with fluoroscopy versus fluoroscopy for lumbar selective nerve root block

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Original Article

Author Details : Prem Kumar, Arun Vignesh P S*, Benjamin Vinodh Joshua, Naveen Sathiyaseelan, Nitesh Kumar Rathi

Volume : 12, Issue : 1, Year : 2025

Article Page : 36-42

https://doi.org/10.18231/j.ijca.2025.006

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Abstract

Background: Leg pain is one of the symptoms of lumbar radiculopathy. Diagnostic selective nerve root blocks inject local anaesthetic or other drugs around spinal nerves. The C-arm has been in use for a while. Use of the Ultrasound-guided C-arm method has produced encouraging results. Our goal was to determine whether, in comparison to using C-arm alone, using ultrasonogram in conjunction with it would result in more benefits.
Aim: To determine potential benefits of using USG as an adjuvant to fluoroscopy for lumbar selective nerve root over conventional technique of using fluoroscopy alone.
Materials and Methods: A randomized controlled study was conducted prospectively between 2016 & 2019 involving 78 patients who complained of radicular pain with or without mild back pain. Selective nerve root block was performed under fluoroscopy in group A and one under ultrasound guidance/C-arm in group B. The patient were asked to rate their pain periodically between 2 day and 6 month.
Results: Among 78 patients, 39 patients underwent the procedure under C - arm guidance (Group A), and 39 patients under C-arm and USG guidance (Group B). Of the total 78 patients concordant pain was elicited in 61 patients (78%). No pain relief was seen in 17(22%) patients in whom concordant pain was not elicited. So of the total 78 patients, 65(83%) patients had pain relief and 13(17%) patients required surgery.
Conclusion: US guided selective nerve root block with fluoroscopy as an adjuvant versus fluoroscopy alone was similar in terms of pain relief and functional outcome. On the other hand, US guided selective nerve root block with fluoroscopy as an adjuvant has the advantage of reduced radiation exposure. Hence, we conclude that US guided selective nerve root block with fluoroscopy as an adjuvant is a reasonable alternative to fluoroscopic guided selective nerve root block.
 

Keywords: Lumbar disc, Lumbar radiculopathy, Selective nerve root block, Ultrasonography.

How to cite : Kumar P, Arun Vignesh P S, Joshua B V, Sathiyaseelan N, Rathi N K, Randomised controlled trial comparing the efficacy of ultrasound along with fluoroscopy versus fluoroscopy for lumbar selective nerve root block. Indian J Clin Anaesth 2025;12(1):36-42

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