Abstract：
INTRODUCTION:Much literature reports on selective nerve root blocks (SNRBs) in cases of lumbosacral radiculopathy. Unfortunately, authors only inconsistently reveal the exact needle tip position relative to the causative pathology at the time of injection. Different injection sites may provide different symptomatic benefits. We investigated the variation in injection techniques of practitioners working in the UK. METHODS:A clinical scenario was devised depicting a patient with radiculopathy secondary to an L4/5 vertebral disc prolapse. Participants were questioned on their chosen management of this patient, focusing particularly on SNRB technique. Questionnaires were sent to spinal surgeons, pain management specialists and musculoskeletal radiologists. RESULTS:A total of 100 responses were detailed enough for inclusion. The majority (83%) of respondents reported they would inject local anaesthetic and steroids, 4% would inject local anaesthetic alone and 13% would inject a different substance. Over half (53%) would target the L5 nerve root, 26% the L4 nerve root, 12% the prolapsed disc itself and 9% two separate vertebral levels. Variation was also noted in needle tip location relative to the neural sheath. CONCLUSIONS:When treating lumbar radiculopathy, there are apparent variations in the use and positioning of SNRBs for a given level of disc pathology. Needle tip position may have a direct influence on clinical outcome following SNRBs. Caution is therefore required when considering the validity of previously published studies investigating SNRBs and different injectates.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Eastley NC,Spiteri V,Newey MLdoi
10.1308/003588413X13629960048073subject
Has Abstractpub_date
2013-10-01 00:00:00pages
515-8issue
7eissn
0035-8843issn
1478-7083journal_volume
95pub_type
杂志文章abstract：:John Hunter's many contributions to surgery include the development of the scientific approach and possibly the first use of evidence-based medicine. This oration, concentrates on two other areas ? first, some of his contributions to orthopaedics and secondly past, present and future surgical training and competence. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 传,历史文章
doi：10.1308/147870805x28154
更新日期：2005-05-01 00:00:00
abstract：:A case of trephine colostomy is presented in which air insufflation incorrectly identified the distal limb. Disaster was averted by correct identification at laparotomy. The probable cause of the error and methods of avoidance are discussed. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：INTRODUCTION:Wound ooze is common following total knee arthroplasty (TKA) and persistent wound infection is a risk factor for infection, and increased length and cost of hospitalisation. PATIENTS AND METHODS:We undertook a prospective study to assess the effect of tourniquet time, peri-articular local anaesthesia and ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
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abstract：:The history of the technique of promoting dissolution of retained gallstones in the biliary tree is briefly reviewed. Present methods are described in detail and our own experience recorded. We have treated six patients with retained calculi by means of heparinized saline and sodium cholate infusions of the common bil...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1977-03-01 00:00:00
abstract：INTRODUCTION:The increased use of diagnostic laparoscopy for management of right iliac fossa pain may have lowered the threshold for removing normal appendices, particularly as there is a perception that this practice carries little additional morbidity. The aim of this retrospective audit was to determine the negative...
journal_title：Annals of the Royal College of Surgeons of England
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更新日期：2002-09-01 00:00:00
abstract：:Aggressive angiomyxoma (AAM) was first reported in 1983 as a distinct, slow growing, benign but locally infiltrative, soft tissue tumour. It usually arises in the pelvic and perineal organs, mostly in women. A 47-year-old woman was found to have a large encapsulated retroperitoneal aggressive angiomyxoma. The mass was...
journal_title：Annals of the Royal College of Surgeons of England
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journal_title：Annals of the Royal College of Surgeons of England
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更新日期：1988-09-01 00:00:00
abstract：INTRODUCTION:The aims of this study were to audit the outcome of elective open abdominal aortic aneurysm (AAA) repair in a district general hospital, as well as investigate the true costs for this procedure in relation to the national tariff. PATIENTS AND METHODS:A database is maintained on AAA surgery in the trust. D...
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更新日期：2010-01-01 00:00:00
abstract：:The management of patients with severe hepatic trauma and damage to the inferior vena cava presents many difficulties. Our experience suggests that vena caval injury is more common than has previously been reported. In spite of the severity of the injuries a period for resuscitation is usually available and operation ...
journal_title：Annals of the Royal College of Surgeons of England
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更新日期：1977-11-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588407X205341
更新日期：2007-10-01 00:00:00
abstract：:Over the past 15 years, 32 cases of tuberculosis have been seen and diagnosed in the surgical and gynaecological departments of the Northern General Hospital, Sheffield. The average age of patients was 42.8 years. Of the sites affected, 17 had head, neck or axillary swellings, 6 affected the female genital tract, 3 ha...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1988-05-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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doi：
更新日期：1974-08-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,评审
doi：10.1308/003588410X12628812458932
更新日期：2010-03-01 00:00:00
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pub_type： 杂志文章
doi：10.1308/003588414X14055925060794
更新日期：2015-03-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588407X209347
更新日期：2007-10-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：INTRODUCTION:Modernisation of Medical Careers dictates a shortening of the training required to achieve consultant status. Precisely what type of work these consultants could be expected to accomplish, and be trained to do, is not clear. The objective of this study was to demonstrate a method of stratifying urological ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/1478708051748
更新日期：2005-09-01 00:00:00
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更新日期：2012-03-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1988-11-01 00:00:00
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更新日期：2000-05-01 00:00:00
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更新日期：2011-10-01 00:00:00
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更新日期：2019-03-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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更新日期：1992-09-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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更新日期：2011-07-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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更新日期：2001-05-01 00:00:00
abstract：:In spite of the suitability of the day surgery environment for most patients undergoing elective plastic surgery, day plastic surgery has not been universally adopted in the United Kingdom. The experience of one plastic surgeon gained in treating 5970 patients as day cases out of a total of 12,461 patients over 10 yea...
journal_title：Annals of the Royal College of Surgeons of England
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doi：
更新日期：1994-03-01 00:00:00
