A cervical selective-nerve-root block is a special variation of an epidural steroid injection that is used to help identify the specific nerve root that is the source of neck and arm pain. It contains only local anesthetic and no steroid so is most often a diagnostic block as opposed to a therapeutic block. Although MRI scans and other imaging tests are helpful in identifying pain targets for treatment, they may not be able to identify a specific level of the pain source if there are many different levels of MRI abnormalities.
The Cervical Selective-Nerve-Root-Block Procedure
A small needle is inserted into the epidural space, which is the sac of fluid that protects the spinal cord and its nerves. Fluoroscopy is used to position a small needle into the window where a nerve root exits the epidural space and outside of the nerve root. A small amount of local anesthetic is placed via the needle to just encompass the nerve root and cause it to stop transmitting pain. When done at different levels over a series of blocks, it can be determined which nerve root may be the one causing the pain, which can then be specifically addressed by a therapeutic option. Fluoroscopy or other imaging techniques may be used to verify that the needle is positioned properly. Once the needle is in the correct place, an anesthetic and a steroid are injected into the epidural space.
Recovery from a Cervical Selective-Nerve-Root Block
A patient usually returns home on the day of the cervical selective-nerve-root-block procedure, and is usually able to return to work the next day. Immediately after the procedure, a patient often experiences relief from pain, although pain can then worsen for a day or two (this is completely normal). In most cases, the patient experiences full pain relief within a week.
Complications of a Cervical Selective-Nerve-Root Block
Although complications from a cervical selective-nerve-root block are uncommon, they do exist, and include the following:
- Pain at the injection site
- Nerve damage
The steroid medication can also cause insomnia, fluid retention and changes in blood pressure.
Results of a Cervical Selective-Nerve-Root Block
The effectiveness of a cervical selective-nerve-root block varies. Some patients only experience pain relief for a few months, while others enjoy long-term relief.