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Getting to the Nerve Root of Spinal Pain

Steroid injections have been used to treat pain from spinal nerve roots since the 1950s. Doctors injected blindly by relying on anatomy. They couldn't actually see what was going on inside the spine. This all changed with recent progress in medical imaging.

With a special form of X-ray imaging called fluoroscopy, the needle is guided to the right spot. A fluoroscope is a special type of X-ray that allows the doctor to see an X-ray picture continuously on a TV screen. This method also makes delivery of drugs, such as steroids, safer and easier.

In this study, doctors from several pain clinics put their research efforts together. They used fluoroscopy to guide a needle and a thin tube to a specific spinal level. Electrical current delivered through this pathway was used to find the exact nerve causing pain.

This new method of spinal steroid injection does two things. It shows which nerve is causing the problem. It also allows delivery of steroid drugs to the correct spinal nerve root.

By guiding the medicine to the right spot, patients may get enough pain relief to avoid surgery. And it reduces accidental injection of the medicine into the nearby blood vessels.

References: Thomas M. Larkin, et al. A Novel Technique For Delivery of Epidural Steroids and Diagnosing the Level of Nerve Root Pathology. In Journal of Spinal Disorders. April 2003. Volume 16. No. 2. Pp. 186-192.

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