Usefulness of spinal epidural block for lumbar disc herniation
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概要
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The effectiveness of continuous spinal epidural block for lumbar disc herniation was investigated in 49 patients, retrospectively. Every patient had intracanal disc herniation in the L4/5 or L5/S disc level. Twenty patients showed central, 21 centrolateral and 8 subradicural type of disc herniation in CT scans or MR images. The outcome was analyzed by the scoring system of the Japanese Orthopedic Association, its ratio of improvement (JOA-ratio), a ratio of improvement in straight leg raising test (SLRT-ratio). The block was considered to be effective in patients whose final JOA-ratio was over 60%. Effective block was obtained in 38 cases (73%) but not in 13 (27%). The duration of treatment averaged 28 days (6-70 days) when the block was effective and 46 days (25-92 days) when it was not effective. The effective cases were higher in the patients having the central or centrolateral type of disc herniation than in those having the subradicular type. The serial SLRT-ratio rose rapidly or gradually in the effective cases, although it continued to be low in the ineffective cases. Especially, the SLRT-ratio of the ineffective cases did not rise in the third and fourth week compared to the gradually improved patients. The block is useful for the central or centrolateral type of lumbar disc herniation. Whether the block is to be considered effective should be determined at 4 weeks.
- 日本腰痛学会の論文
日本腰痛学会 | 論文
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