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  • Neck Patient, tell us about Selective Nerve Root blocks

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    Old 09-18-2007, 04:45 PM   #1
    julyg
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    Neck Patient, tell us about Selective Nerve Root blocks

    I saw you mention this as an option when an epidural does not work.

    How long was you relief?
    What is the proceedure?
    Pain Mgmt Doc?
    Multi-levels tell me more

    July

     
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    Old 09-19-2007, 01:46 AM   #2
    PNo
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    Re: Neck Patient, tell us about Selective Nerve Root blocks

    Sorry its, long - I hope this info helps.

    Injections may be called ESI by your dr. under the common name. When you have consults be sure to ask for a complete description. Under the heading of cervical ESI there are actually 2 types of cervical ESIs that I know of:

    interlaminar - injection is in the middle of the epidural space at the level they pick and this is a more general ESI .
    ***this can also be given via a fine catheter they insert, I found those to be very painful even under the local. my doc used this technique to handle multiple levels at once.

    transforaminal - a specific nerve root level . The transforaminal is also called selective nerve root block. the medicine they inject is purposely put specifically right around the nerve root itself using fluroscope guidance. they inject die around the root first to see it and make sure they load the medicine right at that root. they can do multiple levels in a session.

    I have also had interscalene blocks, for problems at C5-7. if you have surgeries and still have pain, this is something they can try to get a little further down the root. not commonly used by all pain management docs, but getting more attention.

    Interlaminar are mostly of use when the pathology is located centrally in the spinal canal (e.g., central disk extrusion) or when one or two individual nerves can not be identified as the most likely source of pain. Conventional epidural injection of steroids can be described as a “general” approach, covering many spinal levels but administering only a small amount of steroid at each level. SNRB is more of a “target” approach, with the injection of a relatively large amount of steroid around a specific nerve root.


    Personally I have never gotten "full" relief of symptoms using injections. However, I have experie nced knock down of pain level that lasted for a couple months after receiving transforaminal injections. Bringing down pain levels from 7-8 to 4-6 makes a big difference. I always encourage people to try them when offered.

    The ESIs did nothing for me. I have stenosis and poor spinal fluid flow, they thought this might have prevented good results. My biggest problem are those foramins, they are narrow and keep growing ostephyte ridges. If your problems are at the roots, the SNRB might really help. I had EMG confirmed radiculapthy

    All done by pain management specialists in outpatient center. Seemed to be about same procedures and cost. No food/drink 4 hours prior, someone drive you home, rest after. Transforaminal in the front, interlaminar from the back. I had IVs on all ESIs , with small doses of versed. On the interscalene that doc does not give anything other than the local. and it hurt like heck and I got no relief except spasm.chest pain relief for about 1 week, those were in front, above clavical. some people get lots of relief from these. all my injections have been by fluroscope guidance.


    :TTYL

    Last edited by PNo; 09-19-2007 at 01:55 AM.

     
    Old 09-19-2007, 02:59 PM   #3
    julyg
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    Re: Neck Patient, tell us about Selective Nerve Root blocks

    Thanks for being so detailed!

    Another careful conideration.

     
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