Efficacy of Transforaminal Nerve Root Block for Lumbar Disc Herniation.

Introduction

Lumbar disc herniation is a common cause of monoradicular pain, often managed conservatively. For patients unresponsive to non-operative measures, transforaminal selective nerve root block (SNRB) offers a minimally invasive alternative aimed at reducing inflammation and pain.

Objective

The aim of this study was to evaluate the efficacy of SNRB in patients with monoradicular pain due to lumbar disc herniation and to assess its role in reducing surgical intervention rates.

Materials and methods

A prospective study was conducted on 120 patients with acute (<6 weeks) unilateral radicular pain and magnetic resonance imaging-confirmed single-level disc herniation. Under fluoroscopic guidance, 2 mL methylprednisolone acetate and 5 mL lignocaine were injected at the affected root. Pain relief was assessed using the visual analogue scale (VAS) at 2 weeks and 6 months. Patients with persistent symptoms were offered a repeat block or microdiscectomy.

Results

At 2 weeks, 60 patients (Group 1) achieved good pain relief (VAS < 3), 40 had partial relief (Group 2), and 20 had poor relief (Group 3). At 6 months, 36 of Group 1 maintained satisfactory relief, while 24 experienced recurrence (15 required a repeat block, 9 underwent surgery). In Group 2, 20 improved with conservative care, eight required a repeat block, and 12 underwent surgery. In Group 3, 12 underwent surgery and eight received a repeat block, of which two maintained relief. Early VAS response predicted long-term outcomes and guided further management.

Conclusion

SNRB is an effective, safe, and minimally invasive option for lumbar disc herniation-related radicular pain, providing meaningful pain relief and delaying or reducing the need for surgery.