Diagnostic Cervical Nerve Root Blocks

Abstract

Cervical radiculopathy is a disabling condition frequently encountered. Lateral disc herniation or foraminal stenosis will result in irritation of the cervical nerve roots. Pain may not always be the presenting complaint, as sensory or motor deficits may present without pain. The most common level of root compression is usually C7, followed by C6. In approximately 80% of cases, the symptoms would resolve with medications and physiotherapy. In remaining patients, in whom natural resolution of symptoms is not seen, injection of steroid and local anaesthetic in the nerve root foramen into the peri-radicular space – ‘cervical selective nerve root block’ (CSNRB) – could be effective. Besides ameliorating radiculopathy due to disc herniation and cervical spinal stenosis, CSNRB can improve symptoms temporarily prior to surgery or improve persistent pain after discectomy. Around 70% patients can avoid surgery after diagnostic/therapeutic cervical nerve root blocks.