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KMID : 0388720230300010009
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Journal of Korean Society of Spine Surgery
2023 Volume.30 No. 1 p.9 ~ p.17
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Effectiveness of Sodium Hyaluronate?Hydroxyethyl Starch (HA?HES) for Selective Nerve Root Block in Lumbar Radiculopathy: A Prospective Clinical Trial (Pilot Study)
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Ko Sang-Bong
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Abstract
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Study Design: Prospective study (pilot study).
Objective: To evaluate the usefulness of hyaluronic acid?hydroxyethyl starch (HA?HES) for selective spinal nerve root block (SNRB).
Summary of Literature Review: Hyaluronic acid?carboxymethyl cellulose (HA?CMC) is a potential alternative to corticosteroids.
Materials and Methods: We recruited patients diagnosed with lumbar spinal stenosis, and those with lower leg radiating pain were selected for SNRB and assigned to the test group or control group. The test group received a mixture of 1 mL of HA?HES, 1 mL of lidocaine, 1 mL of bupivacaine, and 1 mL of normal saline, whereas the control group received a mixture of 1 mL of HA?CMC, 1 mL of lidocaine, 1 mL of bupivacaine, and 1 mL of normal saline. The degree of lower leg radiculopathy improvement was evaluated as a percentage. Spinal function was assessed using the Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ), whereas patients’ quality of life was evaluated using the Short Form 36 (SF-36).
Results: At 7 days after SNRB, there was no statistically significant difference between the two groups in the rate of visual analog scale (VAS) score improvement or changes in VAS scores (p=0.054). The change in the ODI over time differed significantly between the groups (p=0.047).
Conclusions: The findings suggest that HA?HES exerts a similar pain control effect to that of HA?CMC during SNRB, with better results in terms of function.
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KEYWORD
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Nerve block, Radiculopathy, Spinal stenosis
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