COMBINED TECHNIQUES OF CAUDAL EPIDURAL BLOCK AND TRANSFORAMINAL NERVE ROOT BLOCK IN THE TREATMENT OF DEGENERATIVE DISEASES OF THE LUMBAR SPINE: A COST-EFFECTIVENESS ANALYSIS

尾部硬膜外阻滞联合经椎间孔神经根阻滞治疗腰椎退行性疾病的成本效益分析

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Abstract

OBJECTIVE: This study aims to assess cost-effectiveness of caudal epidural block with transforaminal nerve root block in the treatment of degenerative diseases of the lumbar spine. METHODS: A total of 47 patients with lumbar sciatica symptoms were included. Low back pain and leg pain were assessed using the visual analogue scale (VAS), both in the pre-procedure and one week after. The cost-effectiveness and value required to improve each point on the VAS were estimated using addition, division, and rule of three calculations. RESULTS: For low back pain, scores ranging from 2 to 10 were found before the procedure, with a mean of 7.5 ± 2.14 (95%CI: 6.8-8.1). A week after, these scores ranged from 0 to 10, with a mean of 3.1±2.8 (95%CI: 2.3-4.0; p < 0.0001). Regarding leg pain, scores ranging from 1 to 10 were noted before the procedure, with a mean of 6.8 ± 2.5 (95%CI: 6.1-7.4). A week after, these scores ranged from 0 to 9, with mean of 2.4 ± 2.5 (95%CI: 1.8-3.1; p < 0.0001). The cost of the materials used during the procedure was 214.72 BRL. CONCLUSION: Caudal epidural with transforaminal nerve root block were a cost-effective treatment modality for patients with degenerative diseases of the lumbar spine. Level of evidence III, Retrospective cohort study.

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