The article discusses the use of selective nerve root blocks and transforaminal epidural injections as a diagnostic tool for low back and lower extremity pain. The study aims to evaluate and update the accuracy of these injections in diagnosing lumbar spinal disorders. The authors conducted a systematic review of relevant literature and assessed the methodological quality of included studies. The results show limited evidence for the accuracy of selective nerve root injections as a diagnostic tool for lumbosacral disorders and their use in the preoperative evaluation of patients with inconclusive imaging studies. However, the authors note the limitations of the review, including a lack of literature and variations in technique and diagnostic criteria. They conclude that further research and consensus are needed to clarify the role of selective nerve root injections in evaluating low back pain with radicular features
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spinal hospital in London
Published article
CONCLUSIONS: There is limited evidence for selective nerve root injections as a diagnostic tool in evaluating low back pain with radicular features. However, their role needs to be further clarified by additional research and consensus.
Laser Spine Surgery Expert. Best Spinal Surgeon UK
Abstract Background: Lumbosacral selective nerve root blocks and/ or transforaminal epidural injections are used for diagnosis and treatment of different disorders causing low back and lower extremity pain. A clear consensus on the use of selective nerve root injections as a diagnostic tool does not currently exist. Additionally, the validity of this procedure as a,
Abstract
Background: Lumbosacral selective nerve root blocks and/ or transforaminal epidural injections are used for diagnosis and treatment of different disorders causing low back and lower extremity pain. A clear consensus on the use of selective nerve root injections as a diagnostic tool does not currently exist. Additionally, the validity of this procedure as a diagnostic tool is not clear.
Objective: To evaluate and update the accuracy of selective nerve root injections in diagnosing lumbar spinal disorders.
Study design: A systematic review of selective nerve root blocks for the diagnosis of low back and lower extremity pain.
Methods: Methodological quality assessment of included studies was performed using the Quality Appraisal of Reliability Studies (QAREL) checklist. Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. Studies scoring less than 50% are presented descriptively and analyzed critically. The level of evidence was classified as good, fair, or limited or poor based on the quality of evidence grading scale developed by the United States Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to September 2012, and manual searches of the bibliographies of known primary and review articles.
Outcome measures: In this review, we evaluated studies in which controlled local anesthetic blocks were performed using at least 50% pain relief as the reference standard.
Results: There is limited evidence for the accuracy of selective nerve root injections as a diagnostic tool for lumbosacral disorders. There is limited evidence for their use in the preoperative evaluation of patients with negative or inconclusive imaging studies.
Limitations: The limitations of this systematic review include a paucity of literature, variations in technique, and variable criterion standards for the diagnosis of lumbar radicular pain.
Conclusions: There is limited evidence for selective nerve root injections as a diagnostic tool in evaluating low back pain with radicular features. However, their role needs to be further clarified by additional research and consensus.
The London Spine Unit : innovative spinal hospital in London
Read the original publication:
Diagnostic utility of selective nerve root blocks in the diagnosis of lumbosacral radicular pain: systematic review and update of current evidence
