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Successful Treatment of Lumbar Radicular Pain with Selective Nerve Root Injection Using a Racz Catheter: A Case Report

Authors Park D, Chang MC

Received 25 February 2020

Accepted for publication 10 April 2020

Published 28 April 2020 Volume 2020:13 Pages 843—845


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Michael Schatman

Donghwi Park,1 Min Cheol Chang2

1Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea; 2Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea

Correspondence: Min Cheol Chang Email

Purpose: Lumbar transforaminal selective nerve root injection (SNRI) is effective for controlling radicular pain. However, when a patient occasionally experiences severe foraminal stenosis, osteophytes cover the outside opening of the neural foramen, preventing clinicians from inserting a needle tip within the neural foramen.
Patients and Methods: An 81-year-old man complained of left L5 radicular pain (left thigh and calf) due to severe left L5-S1 foraminal stenosis. After failure of conventional transforaminal SNRI in the left L5 due to severe degenerative change in the lumbar spine, SNRI was performed using a Racz catheter. After inserting a 16-gauge cannula via the sacral hiatus, the Racz catheter was inserted. The tip of the catheter was positioned near the left L5 nerve root. After confirming the location of the needle tip using a contrast dye, 20 mg (40 mg/mL) of triamcinolone with 0.5 mL of 1% lidocaine and 2 mL of normal saline was injected.
Results: Immediately after the procedure, the patient’s pain completely disappeared. During the 1- and 2-month follow-ups, the patient reported only slight pain in the thigh and calf.
Conclusion: When it is not possible to perform a conventional transforaminal SNRI, SNRI using a Racz catheter can be an effective treatment option for controlling lumbar radicular pain.

Keywords: spinal stenosis, Racz catheter, selective nerve root injection

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