Therapeutic selective nerve root block in the nonsurgical treatment of atraumatic cervical spondylotic radicular pain: A retrospective analysis with independent clinical review

Selective Cervical Nerve Root Blockade: Prospective Study of Immediate and Longer Term Complications

“…In addition to anti-inflammatory effects, corticosteroids may also decrease pain by stabilizing neural membranes and by a direct anesthetic effect on small unmyelinated nociceptive C fibers. 4 Additionally, lidocaine has anti-inflammatory effects and may improve blood flow and reduce neural dysfunction in injured nerve roots. 4 Medication may be delivered nonspecifically via an interlaminar or translaminar epidural steroid injection or may be deposited directly along the nerve root, as a selective nerve root block or transforaminal epidural injection.…”

“…4 Additionally, lidocaine has anti-inflammatory effects and may improve blood flow and reduce neural dysfunction in injured nerve roots. 4 Medication may be delivered nonspecifically via an interlaminar or translaminar epidural steroid injection or may be deposited directly along the nerve root, as a selective nerve root block or transforaminal epidural injection. The addition of local anesthetic with limited injectant volume allows the selective nerve block to function as a diagnostic test, which is particularly useful in cases of multilevel spondylosis.…”

“…The clinical usefulness and efficacy of the procedure has been supported by a number of prospective observational studies. [4][5][6][7][8][9] In addition, studies have supported the relevance of selective nerve root blockade to clinical and MR imaging findings. 10,11 Various techniques have been described for the transforaminal or selective cervical nerve block, but there is agreement that image guidance is imperative for both accuracy and safety.…”

Cervical foraminal selective nerve root block: a ‘two-needle technique’ with results

“…Slipman et al have used a single 22G needle with contrast confirmation of needle position. In their series of 20 patients at a mean of 21.2 month follow-up, 60% had good to excellent results and a third required surgical intervention [8]. Vallee et al reported significant reduction in pain in 62% of 32 patients with cervical radiculopathy treated with SNRBs.…”

“…Surgical treatment is generally reserved for unremitting and severe pain in patients in whom nonoperative treatment has failed [4,5]. One effective modality of treatment for patients with unremitting pain is injection of steroid and local anaesthetic in the nerve root foramen into the peri-radicular space -cervical foraminal 'selective nerve root block' (SNRB) [6][7][8][9][10]. Here we describe a method of SNRB using a 'two-needle technique' with a 2-year follow-up of 30 patients in our centre.…”