Accurate location and minimally invasive treatment of lumbar lateral recess stenosis with combined SNRB and PTED

ObjectiveTo establish a management strategy for multi-segment lumbar lateral recess stenosis.MethodsA retrospective study was performed in patients in whom suspected responsible nerve roots underwent sequential selective nerve root block (SNRB). Based on pain remission rate after blocking, the contribution of nerve root compression to symptoms was classified as absolutely (≥70%) or relatively (30–70%) responsible or non-responsible (ResultsFifty-seven of 80 patients had a single absolutely responsible root, 20 had 2 responsible roots, and 3 had 3 responsible roots. Among them, 41, 10, and 1 patient underwent PTED, respectively. Both the PTED and conservative groups improved significantly in VAS remission rate and functional scores compared with admission. Moreover, the PTED group had a better VAS remission rate compared with the conservative group.ConclusionA combination of SNRB with PTED was effective for diagnosing and treating multi-segment lumbar lateral recess stenosis.