What is the role of thoracic epidural nerve blocks in pain management?

Updated: Jun 19, 2018
  • Author: Anthony H Wheeler, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Answer

Answer

Using the transforaminal approach, epidural spinal block with local anesthetics can also be used to acquire diagnostic information when performing differential neural blockade to determine the anatomic basis of thoracic, chest wall, and abdominal pain. If procedural disruption of the thoracic nerve roots is considered, this technique is useful as a prognostic indicator of the degree of motor and sensory impairment that the patient may experience. Although the interlaminar approach is more commonly used for routine therapeutic thoracic epidural injections, some interventional pain treatment specialists believe that the transforaminal approach is more effective for the treatment of painful conditions involving a single radicular pain syndromes; however, the risk of complications is significantly higher, especially for thoracic radiculopathy caused by neural foraminal stenosis and/or perineural fibrosis. [19, 20, 21]


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