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Cervical Nerve Root Block

What does “Cervical Nerve Root Block” mean?

Here is what each word means:

  1. Cervical: the parts of the spine located in the neck
  2. Nerve Root: The part of the nerve where it leaves the spine
  3. Block: refers to blocking pain

Altogether, “Cervical Nerve Root Block” means placing medication to block a nerve at the point in the neck where the spinal nerve leaves the spine.

Why is a Cervical Nerve Root Block done?

A Cervical Nerve Root Block is a procedure often done as a treatment for pain stemming from disc herniations in the neck. The disc herniation often results in inflammation the spinal nerve next to it, resulting in neck and arm pain. This inflammation is the target of the procedure.

Another reason for a Cervical Nerve Root Block is nerve compression from bone spurs compressing the nerve in the foramen.

What is the difference between a Cervical Interlaminar Epidural Steroid Injection, a Transforaminal Epidural Steroid Injection, and a Cervical Nerve Root Block?

All three injections are often done for inflamed spinal nerves in the neck, most commonly due to a disc herniation. The difference between these injections is where the medication is delivered. Some of this may depend on the location of a disc herniation or the preference of the doctor performing the injection.

Here is where each injection delivers the medication:

  1. Cervical Interlaminar Epidural Steroid Injection:

The medication is injected into the main epidural space on the back of the spine, just outside the spinal cord and its lining (dura). The medication usually spreads over a wide area, i.e. multiple spinal nerves and discs.

     2. Cervical Transforaminal Epidural Steroid Injection:

The medication is injected through the foramen (opening for the spinal nerve to leave the spine), i.e. right next to the inflamed nerve. The medication usually does not travel very far from the nerve.

     3. Cervical Nerve Root Block

This injection is very similar to the Cervical Transforaminal Epidural Steroid Injection. The difference is that the medication is placed next the nerve outside the foramen, i.e. once the nerve has left the spine.

How is a Cervical Nerve Root Block done?

Here are some of the steps of how a Cervical Nerve Root Block is done:

  1. The procedure is usually done in a Procedure Room or Operating Room.
  2. The patient may receive relaxing medication (sedation) with an intravenous catheter (IV).
  3. The patient is usually placed on the back (supine), with the head turned away from the painful side.
  4. The side of the neck is cleaned with a surgical antiseptic and sheets (drapes) are used to keep the area clean.
  5. The doctor will then inject a small amount of a local anesthetic under the skin.
  6. Next, a specialized needle (spinal or procedure needle) is inserted through the anesthetized area.
  7. At this point, typically an X-Ray machine is used to see the tip of the needle as it is slowly advanced towards the foramen (hole for the spinal nerve).
  8. When the needle tip is in a good position outside the foramen, a small amount of contrast material (fluid which looks dark on an X-Ray) is injected to verify that it is in the correct location.
  9. Next, a mixture of medication is injected into the epidural space. This mixture may consist of a steroid and a local anesthetic.
  10. The needle is withdrawn.
  11. A band-aid is placed at the site of the needle puncture.
  12. The patient is then taken to a Recovery Area for a period of observation.

How long does it take to perform this procedure?

Typically a cervical nerve root block takes 5-10 minutes to complete.

How much relief can patients gain from a Cervical Nerve Root Block?

The relief from spine injections can vary. If the injection is done for an inflamed spinal nerve, the relief can be substantial or complete. It could last for weeks to months.