Abstract
Background Lumbar radiculopathy (LR) due to prolapsed intervertebral disc (PIVD) is a prevalent cause of pain and functional limitation. Selective nerve root block (SNRB) is used both diagnostically and therapeutically; however, pragmatic effectiveness data remain limited. Objective This study aims to quantify short‑term changes in pain and disability following fluoroscopy‑guided SNRB for single‑level LR due to PIVD. Materials and methods Prospective observational cohort at a secondary‑care hospital. Adults aged 18-60 years with clinicoradiologic concordance for single‑level LR received SNRB. Outcomes were measured using the Numeric Rating Scale (NRS) for pain and the Oswestry Disability Index (ODI) at baseline, immediately post-procedure (day 0), 30 days, and 90 days. The Straight‑Leg Raise Test (SLRT) was assessed at each visit. Paired comparisons evaluated changes from baseline; 30‑ vs. 90‑day differences were also tested. Results Thirty‑five patients were included. Mean NRS decreased from 6.40 ± 0.78 at baseline to 3.29 ± 0.57 (day 0), 3.17 ± 0.64 (30 days), and 3.14 ± 0.55 (90 days); all comparisons vs. baseline p = 0.0001; 30 → 90 days p = 0.201. ODI improved from 14.31 ± 3.43 to 7.83 ± 2.26 (day 0), 7.86 ± 2.68 (30 days), and 6.86 ± 2.39 (90 days); all p = 0.0001 vs. baseline. SLRT converted from positive pre‑procedure to negative immediately and at 30 days, with partial recurrence in 4/35 (11.4%) at 90 days. Conclusions In this cohort, fluoroscopy‑guided SNRB produced rapid and durable improvements in pain and disability through three months, supporting its use as an intermediate option between initial conservative care and surgery when clinical and imaging findings are concordant. Larger randomized or comparative‑effectiveness studies with longer follow‑up are warranted to assess durability, define predictors of response, and optimize patient selection.