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Pain origin difficult to diagnose in patients with lumbar spinal stenosis, hip osteoarthritis
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When using spinal nerve block and hip joint block in patients with degenerated hip joint and lumbar spinal disease, it is difficult to determine the origin of the lower leg pain and must be taken into consideration before surgery, according to this study.
Researchers reviewed 420 patients who had leg pain with lumbar spinal stenosis diagnosed by myelography, CT after myelography or magnetic resonance imaging. Four patients who had lumber spinal stenosis and hip osteoarthritis had pain only at ipsilateral lateral aspect of the lower leg by slightly low back pain or pain around the hip joint. After L5 spinal nerve block, researchers found the symptoms resolved. However, symptoms remained after lidocaine infiltration into the hip joint. For the four patients, researchers performed decompression and postlateral fusion surgery.
Overall, leg pain did not resolve after lumbar surgery in all patients. According to study results, conservative treatment was not effective from 6 months to 12 months. Researchers performed ipsilateral total hip replacement for all patients, who became symptom free.
Disclosure: The researchers had no relevant financial disclosures.
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