Diagnostic Lumbar Nerve Root Block

Jönsson, Bo; Strömqvist, Björn; Annertz, Mårten; Holtås, Stig; Sundén, G

doi:10.1097/00002517-198803000-00009

Cited by 11 publications

(13 citation statements)

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“…One study was a diagnostic cohort study, 28 one was a RCT 42 and five studies were case series. 25,[43][44][45][46] Publication dates ranged from 1973 to 2010. Only one study 25 reported on the complications of SNRBs in the lumbar spine as the primary outcome of interest.…”

Section: Summary Of Test Accuracy Resultsmentioning

confidence: 99%

“…This study included all patients (n = 1203) who received one or more therapeutic or diagnostic SNRBs in a radiology department with no details provided on their pre-test symptoms. The remaining six studies 28,[42][43][44][45][46] were all conducted among participants with radicular pain in a lower limb but were generally small (15-117 participants analysed). Table 7 gives full details of the SNRB injection methods and the adverse events reported.…”

Section: Summary Of Test Accuracy Resultsmentioning

confidence: 99%

“…Table 7 gives full details of the SNRB injection methods and the adverse events reported. The needle gauge was reported in five 25,[43][44][45][46] out of seven studies and ranged from 20 to 25. The needle length, reported in three studies, 43,45,46 ranged from 8 cm to 15 cm.…”

Section: Summary Of Test Accuracy Resultsmentioning

confidence: 99%

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The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model

Beynon

Hawkins²,

Laing³

et al. 2013

Health Technol Assess

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Reports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 09/111/01. The contractual start date was in August 2010. The draft report began editorial review in February 2012 and was accepted for publication in October 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health.

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Section: Summary Of Test Accuracy Resultsmentioning

confidence: 99%

Section: Summary Of Test Accuracy Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model

Beynon

Hawkins²,

Laing³

et al. 2013

Health Technol Assess

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show abstract

“…For better understanding of these problems, many authors have used diagnostic as well as therapeutic injections for investigation and treatment of painful degenerative spinal disease, especially in the lumbar spine [1,6,11,12,14,26,29]. The value of these injections is continuously under debate, and the main reason for this is that they are used for diagnosis and treatment of many different spinal disorders: low back pain, neck pain, lumbar/cervical facet syndromes, discogenic pain and radicular pain [10,24].…”

Section: Introductionmentioning

confidence: 99%

“…The value of these injections is continuously under debate, and the main reason for this is that they are used for diagnosis and treatment of many different spinal disorders: low back pain, neck pain, lumbar/cervical facet syndromes, discogenic pain and radicular pain [10,24]. Our own experience is that diagnostic selective nerve root blocks (SNRB) with local anaesthetics, might provide information about root origin of radicular pain, when the blocks are performed guided by magnetic resonance imaging (MRI) findings and clinical symptoms in the lumbar as well as in the cervical spine [11]. In patients with cervical radiculopathy and multilevel degeneration, it is often difficult to define the affected root/roots from clinical symptoms and MRI only.…”

Section: Introductionmentioning

confidence: 99%

Selective diagnostic nerve root block for the evaluation of radicular pain in the multilevel degenerated cervical spine

et al. 2005

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In patients with radiculopathy due to degenerative disease in the cervical spine, surgical outcome is still presenting with moderate results. The preoperative investigations consist of clinical investigation, careful history and most often magnetic resonance imaging (MRI) of the cervical spine. When MRI shows multilevel degeneration, different strategies are used for indicating which nerve root/ roots are affected. Some authors use selective diagnostic nerve root blocks (SNRB) for segregating pain mediating nerve roots from nonpain mediators in such patients. The aim of the present study is to assess the ability of transforaminal SNRB to correlate clinical symptoms with MRI findings in patients with cervical radiculopathy and a two-level MRI degeneration, on the same side as the radicular pain. Thirty consecutive patients with cervical radiculopathy and two levels MRI pathology on the same side as the radicular pain were studied with SNRBs at both levels. All patients underwent clinical investigation and neck and arm pain assessment with visual analogue scales (VAS) before and after the blocks. The results from the SNRBs were compared to the clinical findings from neurological investigation as well as the MRI pathology and treatment results. Correlation between SNRB results and the level with most severe degree of MRI degeneration were 60% and correlation between SNRB results and levels decided by neurological deficits/dermatome radicular pain distribution were 28%. Twenty-two of the 30 patients underwent treatment guided by the SNRB results and 18 reported good/excellent outcome results. We conclude that the degree of MRI pathology, neurological investigation and the pain distribution in the arm are not reliable parameters enough when deciding the affected nerve root/ roots in patients with cervical radiculopathy and a two-level degenerative disease in the cervical spine. SNRB might be a helpful tool together with clinical findings/history and MRI of the cervical spine when performing preoperative investigations in patients with two or more level of degeneration presenting with radicular pain that can be attributed to the degenerative findings.Keywords Diagnostic nerve-root block AE Radiculopathy AE MRI AE Cervical spine AE Treatment Eur Spine J (2006) 15: 794-801

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What types of degenerative lumbar pathologies respond to nerve root injection? A retrospective review of six hundred and forty one cases

Kanayama

Oha

Hashimoto

2015

International Orthopaedics (SICOT)

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Diagnostic Lumbar Nerve Root Block

Cited by 11 publications

References 0 publications

The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model

The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model

Selective diagnostic nerve root block for the evaluation of radicular pain in the multilevel degenerated cervical spine

What types of degenerative lumbar pathologies respond to nerve root injection? A retrospective review of six hundred and forty one cases

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