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Complications of Lumbar Nerve Root Blocks

Back pain that goes down the leg is called lumbar radiculopathy. It's caused by chemical irritation or mechanical stress on one or more of the spinal nerves. Selective lumbar nerve blocks (SLNBs) may help the patient avoid surgery. A steroid and a numbing agent are injected into the area around the nerve root.

This study looks at the overall number of immediate problems (small or large) with SLNBs in 1,777 patients. Some patients had a single level SLNBs. Others had an injection at more than one level. The position of the needle tip during the injection was compared for patients with and without complications.

The authors report an overall complication rate of five percent. Problems reported were minor and didn't last. These included feeling lightheaded, new pain, leg numbness, and leg weakness. Increase in the usual back or leg pain was a sign that the right nerve root was being blocked and didn't count as a complication.

Needle-tip position did not seem to matter. The number of injections was more important. The number of problems doubled in patients who had multiple injections at the same time. Long-term results aren't available but from this study it seems that SLNBs are safe and effective.

References: Seth T. Stalcup, et al. Influence of Needle-Tip Position on the Incidence of Immediate Complications in 2,217 Selective Lumbar Nerve Root Blocks. In The Spine Journal. March/April 2006. Vol. 6. No. 2. Pp. 170-176.

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