The nerve root block or selective nerve root block is one of the primarily preoperative diagnostic tool to identify and confirm the lesion site of primary cause of pain and that is considered as one component of a comprehensive treatment program. The purpose of our study is to evaluate the effect and duration of the pain control by selective spinal nerve root block as a conservative treatment in patients presenting with chronic or recurrent sciatica. The authors performed 95 selective nerve root blocks in 72 patients from Sep. 1994 to May. 1996, (mean follow up 11.6 month) at the department of orthopedic surgery, Kosin University Gospel Hospital, and the results were as follows: 1. Among 72 cases, spinal stenosis was in 45 cases (62.5%), HIVD in 19 cases (26.4%), failed back syndrome in 5 cases (6.9%), spondylosis in 2 cases (2.8%), and spondylolisthesis in I case (1.4%). 2. In 72 cases, improved more than 50% of sciatica were 61 cases (84.7%) at 3 hours, 53 cases (73.6%) at I week, 35 cases (48.6%) at 1 month, 33 cases (45.8%) at 3 months, and 33 cases (45.8%) at 6 months respectively. 3. At last follow-up, excellent and good results were 35 cases (48.6%), fair results were 25 cases (34.7%) and poor results were 12 cases (16.7%) by the Kirkaldy-Willis criteria. 4. Complications were 1 case of transient hypotension, 2 cases of severe paresthesia, but subsided without residual complication. Therefore, the selective nerve root block is one of the valuable procedure that is helpful and extremely safe in useful treatment for radicular pain associated with lumbar disease. And the trial of selective nerve root block was recommended before deciding surgical intervention on an outpatient basis.
Follow-Up Studies ; Humans ; Hypotension ; Orthopedics ; Outpatients ; Paresthesia ; Sciatica* ; Spinal Nerve Roots* ; Spinal Nerves* ; Spinal Stenosis ; Spondylolisthesis ; Spondylosis

BACKGROUND/AIMS: Pneumatic dilation is the most effective non-surgical treatment option for the patients with achalasia. The aim of this study was to determine the predictors of outcome after pnematic dilation in patients with primary achalasia. METHODS: Thrity-five patients with primary achalasia between May 1996 and April 2001 were included. They were divided into two groups; responder and nonresponder. Esophageal manometry, scintigraphy and barium esophagogram was performed before dilation and 4 weeks after dilation. RESULTS: Seven patients having symptomatic relapse were treated with repeated pneumatic dilation. Remaining 28 patients (83%) had no recurrence during follow-up period (mean duration 16 month, range 6~43 month). Among the factors evaluated in the initial examination, only young age affected outcome (p=0.039). The post treatment retention fraction at 5, 20 minutes were the most valuable factors for predicting the clinical response (p<0.05). CONCLUSIONS: Older patients are more likely to have sustained response. Radionuclide esophageal emptying test remains a useful objective study evaluating esophageal transit before and after pneumatic dilation in the patients with achalasia and may have an important role in the follow-up evaluation of treatment for achalasia.
Barium ; Esophageal Achalasia* ; Follow-Up Studies ; Humans ; Manometry ; Radionuclide Imaging ; Recurrence