A Selective Nerve Root Block is a minimally invasive procedure using fluoroscopy (x-ray guidance) to perform an injection of local anesthetic and steroid around a specific nerve root. It is used to determine if a specific nerve root is the source of pain and to reduce the inflammation around that nerve.
What are the Indications?
Spinal nerve blocks are indicated to relieve pain, weakness, numbness and tingling sensations in your neck, back, and extremities due to nerve injuries such as a pinched nerve or narrowing of the spinal column (stenosis).
Preparing for a selective nerve root block
You should not eat or drink anything 4-6 before the procedure. You may take your medications with a sip of water. You may have to temporarily discontinue certain medications such as blood thinners or diabetic medication. The procedure is not performed if you have an ongoing infection, elevated blood glucose or elevated blood pressure. If you had or are planning to have surgery within 4 weeks or less from the date of your injection, you should discuss it with your surgeon as there may be concern that the steroids could affect your surgical healing.
What to expect during your procedure?
You will check into the facility at your scheduled time. You will be asked to fast for 4-6 hours prior to your procedure. You will be brought back and prepped by a nurse on staff. They will insert the IV for safety and for the conscious sedation if you desire sedation. In the procedure room you will be placed in the prone position and a fluoroscopy machine will be brought into position. Your doctor will then numb the area with a local anesthetic and using live fluoroscopic guidance will use a spinal needle to inject steroid and a numbing agent onto the specific nerve root. When the procedure is complete, the medical assistant will clean up the skin and place a bandage over the injection site. You will then be placed in a post procedure room for about 20-30 minutes and your pain levels will be reevaluated prior to being discharged home.
What to expect after the procedure?
You will be asked not to drive for at least 24 hours after the procedure and you must have a driver drive you home from your procedure. You may experience numbness in your leg for as long as the local anesthetic lasts, which can be up to 12 hours. The day of and the following day you may feel some discomfort in the injection areas. You may have pain relief immediately after the injection, but pain may return after a few hours as the anesthesia wears off. Pain for a few days following the injection can be normal. The steroid will likely decrease the pain but can take up to 5-7 days for full effect.
What risks or complications are associated with the procedure?
As with any procedure, a selective nerve root block may be associated with certain risks and complications such as pain (temporary), bruising, infection at the site of the injection and nerve damage although serious complications are unlikely.
Is there anything my doctor needs to know prior to the procedure?
You should tell your doctor if you are pregnant, on blood thinners, diabetic, or if you have any other concerns you would like to address beforehand.
The above information is for general education purposes only. Please ask your doctor any specific questions you may have during your visit.
