What is the efficacy of selective nerve root blocks (SNRBs) in the treatment of low back pain (LBP)?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Answer

An evidence synthesis by Datta et al revealed limited evidence for the effectiveness of selective nerve root blocks (SNRBs) as a diagnostic tool and found moderate evidence for their diagnostic use in the preoperative evaluation of patients with negative or inconclusive imaging studies. [173] Also, transforaminal epidural injections have shown positive short- and long-term results in multiple randomized trials. [137, 138]

Abdi et al performed a systematic review examining each epidural route's effectiveness. The evidence relating to lumbar transforaminal epidural steroid injections was strong for managing lumbosacral radicular pain on a short-term basis and moderate for long-term effectiveness; however, support was limited for successfully managing lumbar radiculopathy pain that was present following surgery. [174] The evidence was indeterminate with regards to managing axial LBP. [174] The evidence synthesis by Manchikanti demonstrated support for short- and long-term pain relief for transforaminal epidural injections when performed in a series, rather than a single injection.


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