Randomized double-blind placebo-controlled trial of Selective Nerve Root Blockade (SNRB) in acute lumbar disc herniation and sciatica / : Randomized double-blind placebo-controlled trial of SNRB in acute lumbar disc herniation and sciatica

POLICY AND PREVENTION • The results of this study support the use of selective nerve root blockade (SNRB) with CORTICOSTEROID in the first 6 weeks of acute lumbar disc herniation and sciatica but not 12-18 weeks post onset of symptoms. [...] Methodological shortcomings of the studies, heterogeneity of study populations with respect to cause and duration of sciatica, and technical aspects of the injections employed in the trials all have contributed to the inconclusive nature of the findings. [...] With regard to disc morphology and outcome of SNRB, a portion of the data pertaining to this was in the possession of the VGH Spine Clinic and not available for analysis at the time of this report. [...] In terms of policy and prevention, the results of this study support the use of selective nerve root blockade (SNRB) with CORTICOSTEROID in the first 6 weeks of acute lumbar disc herniation and sciatica but not 12-18 weeks post onset of symptoms. [...] While the identification of a single specific anatomic lesion that is causing the pain is not possible in most cases of LBP, one of the few clinical entities in which a close correlation appears to exist between morphological changes and symptoms of back pain is lumbar disc herniation and sciatica19.