The Effectiveness of Selective Nerve Root Injections in Preventing the Need for Surgery
Status:
Completed
Trial end date:
2015-11-01
Target enrollment:
Participant gender:
Summary
The median Orthopaedic surgery wait time in Canada is 36.7 weeks (Esmail 2008), thus there is
a need to find alternative treatments for pathologies such as lumbar disc herniations (LDH).
The literature has demonstrated that selective nerve root injections (SNRI) are able to
alleviate sciatic symptoms caused by LDH (Riew 2006) and may be beneficial as an alternative
to surgery. It is necessary to determine whether SNRIs provide significant symptom resolution
alleviating the need for surgery, or to determine if their success is transient and delays
the time to surgery. The purpose of the proposed study is to evaluate the success of SNRI in
patients suffering with LDH and to determine which factors influence outcome. Over the span
of 2 years, data from 100 patients will be collected. These patients will be surgical
candidates and have exhausted all non-operative measures prior to receiving a SNRI. Upon
first assessment, each eligible patient will be randomly assigned to the treatment (steroid)
or control (saline) group. The patient and all treating physicians will be blinded to the
treatment given. Each patient will be followed over their course of treatment and information
pertaining to their pain and symptoms will be recorded using standard questionnaires. Patient
demographics, diagnosis, Worker's Compensation status, spinal levels treatment/outcome, and
time from referral to treatment will also be evaluated. The primary outcome measure will be
defined as the avoidance of surgery.