Hongping Tan,1,* Jing Zhou,2,* Yijin Pu,1 Lin He,1 Liu Wang3 

1Department of Pain Management, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, People’s Republic of China; 2Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, People’s Republic of China; 3Department of Pain Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530007, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Liu Wang, Email painless@sr.gxmu.edu.cn

Background: Lumbar disc herniation (LDH) is a common cause of low back pain and radiculopathy. Selective Nerve Root Block (SNRB) has been widely used as a treatment for LDH; however, its efficacy across different types of LDH remains unclear. This study aims to evaluate the clinical efficacy of SNRB in treating various LDH subtypes, classified according to the Michigan State University (MSU) classification system, and to explore its potential as a safe and minimally invasive percutaneous treatment option.
Methods: This is a single-blind, Prospective Cohort Study. A total of 200 patients diagnosed with LDH will be recruited and allocated into 10 groups (20 patients per group) based on their MSU classification (1-A, 1-B, 1-C, 2-AB, 2-A, 2-B, 2-C, 3-AB, 3-A, and 3-B). All patients will receive SNRB treatment under fluoroscopic guidance. Primary outcomes will include the Visual Analogue Scale (VAS) for pain intensity. Secondary outcomes will include the Oswestry Disability Index (ODI), health-related quality of life (Short Form-36, SF-36) and average weekly analgesic consumption. Assessments will be conducted at baseline, 1 day, 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year post-treatment.
Discussion: This study will provide high-quality evidence on the efficacy of SNRB in different LDH subtypes, classified according to the MSU system. The findings will guide clinical decision-making and promote the adoption of SNRB as a minimally invasive, safe, and effective treatment option for LDH.
Trial Registration: This clinical trial is registered on the Chinese Clinical Trial Registry platform (ChiCTR) at https://www.chictr.org.cn/index.html, identifier: ChiCTR2200067212.

Keywords: lumbar disc herniation, selective nerve root block, prospective cohort study, pain management, MSU classification