Selective nerve root blocks and transforaminal epidural steroid injections

Sekhadia, Mehul; Benzon, Honorio T.

doi:10.1016/b978-1-4377-2242-0.00054-7

Essentials of Pain Medicine 2011

DOI: 10.1016/b978-1-4377-2242-0.00054-7

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Selective nerve root blocks and transforaminal epidural steroid injections

Mehul Sekhadia¹,

Honorio T. Benzon²

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2023

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Cited by 1 publication

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Spine-Related Procedures

Ghaly¹,

Zaky²

2023

Advanced Anesthesia Review

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Neuraxial anesthesia types (i.e., epidural, spinal, and caudal anesthesia) are the most commonly used regional anesthetic techniques. These techniques not only provide means for anesthesia during surgery but also are commonly used for perioperative analgesia, in-labor analgesia, and chronic pain management. Preoperative evaluation is crucial and involves detailed history and examination as well as evaluation for contraindications. Different approaches are described and are dictated by a patient’s anatomy and medical condition. Midline is the most common approach used for spinal, epidural, and combined spinal epidural anesthesia. The paramedian approach has its advantages and can be used alternatively. The paramedian approach bypasses supraspinal and interspinal ligaments and provides direct access to the ligamentum flavum. The caudal epidural is commonly used in the pediatric population and chronic pain management. A transforaminal approach provides a more selective epidural spread in some painful conditions, such as lumbar radiculopathy and postlaminectomy syndrome. Axial low back pain due to facet arthropathy can be managed by facet joint injection or medial branch blocks, which are usually done under fluoroscopy. Ultrasound guidance is becoming more popular as it provides additional safety and improved accuracy during performance of regional anesthesia.

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Spine-Related Procedures

Ghaly¹,

Zaky²

2023

Advanced Anesthesia Review

View full text Add to dashboard Cite

show abstract

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Selective nerve root blocks and transforaminal epidural steroid injections

Cited by 1 publication

References 56 publications

Spine-Related Procedures

Spine-Related Procedures

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