Nerve root infiltrations
Nerve root infiltrations are used in particular for pain that originates from the spine and spreads into the arms, legs or ribs; this is called radicular pain.
In the case of different illnesses, the nerves that leave the spinal cord near the cervical, thoracic and lumbar vertebrae can cause pain. The pain is usually caused by a narrowing of the points at which the nerves exit the spinal column – neuroforaminal stenoses – these may occur in the case of osteoarthritis, spinal stenosis, intervertebral protrusions and slipped discs, scarring around the nerve roots following operations, and in the case of spondylolistheses. Peripheral nerve root injuries or chronic inflammations may also be the cause.
There are different nerve root infiltration techniques including periradicular therapy or PRT, which involves placing a needle near the nerve root outside the spine, and the transforaminal technique, which involves placing the needle into the neuroforamen, very close to the nerve root.
Using x-ray to check that it is in precisely the correct position, a syringe is placed on the nerve roots/nerve root ends and its position is checked using a small amount of contrast medium. If the syringe is in the right place, a local anaesthetic is injected, usually along with cortisone.
Pain is reduced for as long as the painkiller is effective.
Life-threatening complications and serious drug intolerances are extremely rare. Injuries to blood vessels, haematomas and infections are also rare. Particularly rare are cases of nerve damage resulting in lasting paralysis, sensory impairment or pain. Often, the leg, ribs or arm may become numb after a nerve root block, and may remain without sensation for at least 2-6 hours. In this case, neither walking nor standing is possible until the effect of the anaesthetic wears off once again.
As we carry out these infiltrations very frequently, we have developed an approach that involves very little pain. The procedure usually does not even last 5 minutes.