A nerve root sleeve injection (NRSI) or nerve root block refers to an injection into the space surrounding a spinal nerve root. It can be used to diagnose (diagnostic) the source of nerve root pain as well as provide pain relief (therapeutic).
Nerve root sleeve injections are usually performed under X-ray (fluoroscopy) guidance. This aids the surgeon in accurate positioning of the needle. Depending on the location of pain, a local anaesthetic is injected around the specific nerve root; it can be either in the neck (cervical) or in the back (thoracic or lumbar) region. A small amount of contrast material is injected to confirm the positioning of the needle tip. Then a local anaesthetic and steroid is injected, through the needle, to reduce inflammation and decrease your pain.
Cervical nerve root sleeve injection: For cervical nerve root sleeve injection, the patient lies on their back, on the operating table. The head is placed on a head ring. The skin on the side of your neck is anaesthetised by injecting a local anaesthetic.
Lumbar and thoracic nerve root sleeve injection: For a lumbar and thoracic nerve root sleeve injection the patient lies on their stomach, on the operating table. The skin over the lower back is then anaesthetised with a local anaesthetic.
Following the injection, you will be monitored for about 30 minutes before you are discharged home. Following a sleeve injection, you may experience mild pain. You also may be referred to a physical therapist to start a physical therapy program. You should avoid driving on the day of your procedure so you will need to arrange for a ride home.
Some of the complications of NRSI include infection, bleeding, nerve injury, paralysis, and cerebrospinal fluid leakage.