scholarly journals The Role of Diagnostic Selective Nerve Root Blocks in the Management of Spinal Pain

2001 ◽  
Vol 3;4 (7;3) ◽  
pp. 214-226
Author(s):  
Curtis W. Slipman
Keyword(s):  
Nerve Root ◽  
Spinal Pain ◽  
Nerve Root Blocks

Cervical Nerve Root Blocks: Indications and Role of MR Imaging

Radiology ◽  
2004 ◽  
Vol 233 (1) ◽  
pp. 87-92 ◽  
Author(s):  
Klaus Strobel ◽  
Christian W. A. Pfirrmann ◽  
Marius Schmid ◽  
Juerg Hodler ◽  
Norbert Boos ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Nerve Root ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Nerve Root Blocks

scholarly journals An Updated Systematic Review of the Diagnostic Utility of Selective Nerve Root Blocks

2007 ◽  
Vol 1;10 (1;1) ◽  
pp. 113-128
Author(s):  
Sukdeb Datta
Keyword(s):  
Systematic Review ◽  
Diagnostic Tool ◽  
Nerve Root ◽  
Predictive Value ◽  
Spinal Pain ◽  
Diagnostic Utility ◽  
Extensive Literature ◽  
Spinal Disorders ◽  
Cochrane Reviews ◽  
Nerve Root Blocks

Background: Selective nerve root blocks or transforaminal epidural injections are used for diagnosis and treatment of different spinal disorders. A clear consensus on the use of selective nerve root injections as a diagnostic tool does not currently exist. Additionally, the effectiveness of this procedure as a diagnostic tool is not clear. A systematic review of diagnostic utility of selective nerve root blocks was performed and published in January 2005, which concluded that selective nerve root injections may be helpful as a diagnostic tool in evaluating spinal pain with radicular features, but its role needs to be further clarified. Objective: To evaluate and update the accuracy of selective nerve root injections in diagnosing spinal disorders. Study Design: A systematic review of selective nerve root blocks for the diagnosis of spinal pain. Methods: A systematic review of the literature for clinical studies was performed to assess the accuracy of selective nerve root injections in diagnosing spinal pain. Methodologic quality evaluation was performed utilizing Agency for Healthcare Research and Quality (AHRQ) and Quality Assessment Studies of Diagnostic Accuracy (QUADAS) criteria. Studies were graded and evidence classified into 5 levels: conclusive, strong, moderate, limited, or indeterminate. An extensive literature search was performed utilizing resources from the library at Vanderbilt University Medical Center, PubMed, EMBASE, BioMed, and Cochrane Reviews. Manual searches of bibliographies of known primary and review articles, and abstracts from scientific meetings within the last 2 years were also reviewed. Results: There is limited evidence on the effectiveness of selective nerve root injections as a diagnostic tool for spinal pain. There is insufficient research for stronger support, but the available literature is supportive of selective nerve root injections as a diagnostic test for equivocal radicular pain. There is moderate evidence for use in the preoperative evaluation of patients with negative or inconclusive imaging studies. The positive predictive value of diagnostic selective nerve root blocks is low, but they have a useful negative predictive value. Conclusion: Selective nerve root injections may be helpful as a diagnostic tool in evaluating spinal pain with radicular features. However, their role needs to be further clarified by additional research and consensus. Keywords: Selective nerve root block, transforaminal epidural injection, spinal pain, discogenic pain, radiculopathy, nerve root pain

scholarly journals The role of needle tip position on the accuracy of diagnostic selective nerve root blocks in spinal deformity

2014 ◽  
Vol 23 (S1) ◽  
pp. 33-39 ◽  
Author(s):  
A. Irwin ◽  
A. L. Khan ◽  
D. Fender ◽  
P. L. Sanderson ◽  
M. J. Gibson
Keyword(s):  
Spinal Deformity ◽  
Nerve Root ◽  
Nerve Root Blocks ◽  
Tip Position

Diagnostic Selective Nerve Root Blocks

1998 ◽  
Vol 10 (2) ◽  
pp. 123-146 ◽  
Author(s):  
Curtis W. Slipman ◽  
Randal A. Palmitier
Keyword(s):  
Nerve Root ◽  
Nerve Root Blocks

scholarly journals Variations in selective nerve root block technique

2013 ◽  
Vol 95 (7) ◽  
pp. 515-518 ◽  
Author(s):  
NC Eastley ◽  
V Spiteri ◽  
ML Newey
Keyword(s):  
Local Anaesthetic ◽  
Nerve Root ◽  
Lumbar Radiculopathy ◽  
Vertebral Disc ◽  
Injection Techniques ◽  
Nerve Root Blocks ◽  
Tip Position ◽  
The Uk ◽  
Selective Nerve Root Block ◽  
Prolapsed Disc

Introduction Much literature reports on selective nerve root blocks (SNRBs) in cases of lumbosacral radiculopathy. Unfortunately, authors only inconsistently reveal the exact needle tip position relative to the causative pathology at the time of injection. Different injection sites may provide different symptomatic benefits. We investigated the variation in injection techniques of practitioners working in the UK. Methods A clinical scenario was devised depicting a patient with radiculopathy secondary to an L4/5 vertebral disc prolapse. Participants were questioned on their chosen management of this patient, focusing particularly on SNRB technique. Questionnaires were sent to spinal surgeons, pain management specialists and musculoskeletal radiologists. Results A total of 100 responses were detailed enough for inclusion. The majority (83%) of respondents reported they would inject local anaesthetic and steroids, 4% would inject local anaesthetic alone and 13% would inject a different substance. Over half (53%) would target the L5 nerve root, 26% the L4 nerve root, 12% the prolapsed disc itself and 9% two separate vertebral levels. Variation was also noted in needle tip location relative to the neural sheath. Conclusions When treating lumbar radiculopathy, there are apparent variations in the use and positioning of SNRBs for a given level of disc pathology. Needle tip position may have a direct influence on clinical outcome following SNRBs. Caution is therefore required when considering the validity of previously published studies investigating SNRBs and different injectates.

The Problem With Diagnostic Selective Nerve Root Blocks

Spine ◽  
2012 ◽  
Vol 37 (24) ◽  
pp. 1991-1993 ◽  
Author(s):  
Rinoo V. Shah
Keyword(s):  
Nerve Root ◽  
Nerve Root Blocks

Role of Peripheral Mechanisms in Spinal Pain Conditions

2009 ◽  
pp. 21-40
Author(s):  
Brian E. Cairns ◽  
Pradit Prateepavanich
Keyword(s):  
Spinal Pain
Sign in / Sign up

Export Citation Format

Share Document