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The Therapeutic Effect of Postganglionic Nerve Block for Symptomatic Schmorl Nodule: A Retrospective Case Series

증후성 쉬모를 결절에 대한 신경절 이후 신경차단술의 치료 효과: 후향적 증례 분석

  • Son, In Seok (Department of Orthopedic Surgery, Konkuk University Medical Center) ;
  • Hwang, Suk Hyun (Department of Orthopedic Surgery, Seoul Red Cross Hospital) ;
  • Lee, Suk Ha (Department of Orthopedic Surgery, Konkuk University Medical Center) ;
  • Kang, Min Seok (Department of Orthopedic Surgery, Seoul Chuk Hospital)
  • 손인석 (건국대학교병원 정형외과학교실) ;
  • 황석현 (서울적십자병원 정형외과학교실) ;
  • 이석하 (건국대학교병원 정형외과학교실) ;
  • 강민석 (서울척병원 척추센터)
  • Received : 2018.08.30
  • Accepted : 2018.10.12
  • Published : 2018.12.30

Abstract

Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

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