Selective Nerve Root Block

This minimally invasive procedure is injection that is designed to find the source of a patient’s spine pain. It can also work to reduce inflammation around the nerves to lessen any pain. It is both a pain management procedure and a diagnostic test. Medication is injected into the nerve root and the response is monitored. This will help determine whether the nerve that is injected is the true source of the pain. The pain can then be eliminated once the nerve is identified. It can allow the patient to return to their normal activities with full functionality and less pain.

This is a very straightforward procedure. The patient is given a local anesthetic around the injection site. The spinal nerve root is then locate and a needle is inserted into a surrounding area. The medication is then injected so that it can help reduce the inflammation and swelling which will reduce the pain. If the patient responds to the injection, it is clear that it is the source of the pain. Further diagnostics may be needed if the block does not work properly.

The injection site is numbed using a local anesthetic which will minimize the pain. There may be mild discomfort from the injection site. Most of the pain and discomfort with this procedure will come from the actual injection but the local anesthetic will take the edge off.

If the proper root nerve has been injected, it will reduce the amount of pain within a few days and then it is known that that was the cause of the pain.

There are only a few risks with the selective nerve root block procedure. Some of these risks include injection site pain which is usually only temporary. There have been cases where the “sack” containing the spinal fluid has been inadvertently punctured and if so it may cause headaches. Other side effects include bleeding, nerve damage, infection, and ineffectiveness to control the pain.

Patients who may be allergic to any of the medications being injection, are on medications that thin the blood, or if the patient is experiencing an infection.

Right after the surgery, the patient will experience heaviness or numbness in the limbs that are along that specific nerve root. The pain should be significantly decreased but this is likely only due to the local anesthetic that was used and will likely only last a few hours. The pain will usually return and continue for a few days. It is recommended that the patient takes it easy for a day or two after the procedure. Patients should only perform the tasks that do not increase their pain and should refrain from any activities that cause stress. Ice can be applied to the site to help with the pain.

Eastley, N. C., Spiteri, V., & Newey, M. L. (2013). Variations in selective nerve root block technique. Annals Of The Royal College Of Surgeons Of England, 95(7), 515-518. doi:10.1308/003588413X13629960048073

Narouze, MD MSc, Samer & Vydyanathan, MD, MS, Ameresh. (2009). Ultrasound-guided cervical transforaminal injection and selective nerve root block. Doi: 10.1053/j.trap.2009.06.16