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  • Percutaneous Dorsal Root Ganglion Block for Acute Low Back Pain from Lumbar Osteoporotic Compression Fracture

    Final Number:

    weichao Huang; Jen-Tsung Yang; Ming-Hsueh Lee; Chien-Min Chen; Ping-Jui Tasi; Yu-Jen Kuo; Wei-Yuan Cheng; Chih-Hao Kao

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting

    Introduction: The pain of acute compression fracture may be refractory to conservative treatment. Interventions such as vertebroplasty or transpedicle screw-fixation and fusion may be effective, but complications such as chemical leak, adjacent segment instability are common. Percutaneous dorsal root ganglion block is an alternative therapeutic option, in this study, we evaluated its efficacy and associated complications.

    Methods: A retrospective review of 45 patients with lumbar compression fracture from 2013 to 2015 was performed. Patients treated with percutaneous transforaminal dorsal root ganglion block with xylocaine / triamcinolone, and complete image studies (dynamic lateral X-ray, bone mineral density, and MRI) were included, and those with failed back syndrome, ruptured disc, infection, cancer or dementia were excluded. Treatment response evaluated by SF-36 and NRS was collected, and an acceptable outcome defined as a NRS of 3 or less at different time points were analyzed.

    Results: Of the 45 patients treated, bodily pain of the SF-36 was not significantly different, but a significant difference in physical component score was found in between baseline and post-treatment at 1 year. The changes in mean NRS score to the baseline at day-1 was -5.5 (95 % CI -4.9 ~ -6.2, p<0.001), one week -5.5 (95 % CI -4.9 to -6.2, p<0.001), one month -5.3 (95 % CI -4.6 to -6.0, p<0.001), and one year -5.4 (95 % CI -4.7 to -6.3, p<0.001) were all statistically significant. An acceptable outcome was achieved in 35%(15 out of 43) on day-1, 37% (16 out of 43) in 1 week, 40% (17 out of 43) in 1 month, and 44% (19 out of 43) in 1 year and no complications were found.

    Conclusions: Percutaneous dorsal root ganglion block is an easy and safe option for immediately pain relief in lumbar osteoporotic compression fracture patients who failed conservative treatment.The continuous medication for osteoporosis was still demanded.

    Patient Care: short hospital stay and immediate pain relief without invasive open surgery

    Learning Objectives: By the conclusion of this session, participants should be able to 1)Knowing the pathophysiology of percutaneous dorsal root ganglion block .2)The mechanism of adjacent compression fracture

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