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Thoracic Nerve Root Block

What does Thoracic Nerve Root Block mean?

Here is what each word means:

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

Altogether, “Thoracic Nerve Root Block” means injecting a powerful anti-inflammatory medication around the beginning of the nerve after it leaves the spine, to block pain.

Why is a Thoracic Nerve Root Block done?

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

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

All three injections are often done for an inflamed spinal nerve in the mid-back, 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. Thoracic 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 spread over a wide area, i.e. multiple spinal nerves.

  1. Thoracic Transforaminal Epidural Steroid Injection:

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

  1. Thoracic Nerve Root Block

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

How is a Thoracic Nerve Root Block done?

Here are the steps of how a Thoracic 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 mid-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 placed 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, and a pain killer, or a combination of these medications.
  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 Thoracic Nerve Root Block takes about 5-10 minutes to complete.

What benefit can patients gain from a Thoracic 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 3-6 months.