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Lumbar Nerve Root Block

What does “Lumbar Nerve Root Block” mean?

Here is an explanation of each word:

  1. Lumbar: the part of the spine located in the low-back
  2. Nerve Root: The area of the beginning of the nerve after it leaves the spine
  3. Block: refers to blocking pain

Altogether, “Lumbar Nerve Root Block” means injecting medication around a spinal nerve at the point where it leave the spine.

Why is a Lumbar Nerve Root Block done?

A Lumbar Nerve Root Block is a procedure often done as a treatment for pain from a disc herniation. The disc herniation often results in inflammation the spinal nerve next to it, resulting in low back and leg pain. This inflammation is the target of the procedure. The goal of injecting the steroid is to treat the inflammation.

Another reason for Lumbar Transforaminal Epidural Steroid injections is narrowing of the spinal foramen (opening on the side of the spine where the nerve exits). This condition can be the results of degeneration such as the formation of bone spurs which can put pressure on the spinal nerve.                    

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

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

Here is where each injection delivers the medication:

  1. Lumbar 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.

     2. Lumbar Transforaminal Epidural Steroid Injection:

The injection is done from around the side of the spine. The medication is injected through the foramen (opening where the spinal nerve leaves the spine and travels to the leg) and follows the spinal nerve back into the spine. The injection is done for a specific spinal nerve.

      3. Lumbar Nerve Root Block

This injection is very similar to the Lumbar Transforaminal Epidural Steroid Injection. The difference is that the medication is injected outside of the foramen and follows the nerve away from the spine, rather than back into the spine. The injection is done for a specific spinal nerve.

How is a Lumbar Nerve Root Block done?

Here are the steps of how a Lumbar 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) either by mouth or with an intravenous catheter (IV).
  3. The patient is placed on the stomach (prone)
  4. The low-back 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 appears to be in a good position outside the foramen, a small amount of contrast material (fluid which looks dark on an X-Ray) is injected through the needle 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, a local anesthetic, or a pain killer.
  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 do this procedure?

Typically a Lumbar Nerve Root Block takes 5-10 minutes to complete.

How much relief can patients gain from a Lumbar 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.