Nerve Root Injections

The nerve roots are arranged symmetrically on both sides and exit the spinal canal through small openings located between two adjacent vertebral bodies. In this case, one or several of these nerve roots are affected by an intervertebral disc (disc herniation or disc protrusion), by arthrosis of the small vertebral joints (facet joints), as a consequence of a generalized narrowing of the spinal duct or due to a narrowing of the nerve outlet opening. The goal of infiltration is to mitigate pain through a localized injection of medications. In this way, it is the reintroduction of support measures such as physiotherapy.

Infiltration process of the lumbar nerve root

Infiltration is carried out with the help of computed tomography (CT). In total, you must remain in the upside-down position for about 15 minutes for the planning and infiltration itself. After a brief consultation, the radiologist plans the optimal access route to the nerve root based on some CT images. Once the ideal point is located, the skin is numbed by a fine needle (local anaesthesia). The needle is then introduced in stages, anaesthetizing locally several times until the tip of the needle is close to the nerve root.

This procedure may be combined with a caudal epidural injection for best effect.

During the process, the position of the needle is controlled by some CT images or fluoroscopy (x-ray). Once the needle is located near the nerve root, it is injected a small amount of contrast substance, which should extend along the nerve root. At this time, you may feel a cramping pain in your leg. In case this pain is very intense, the doctor will wait a moment and then inject more slowly. Then a small amount of cortisone and a local anaesthetic are injected through the same needle. After a few minutes, the local anaesthetic should achieve a noticeable relief of pain.

Cortisone prevents local inflammation

When the effect of local anaesthesia disappears (a few hours), you may again partially perceive your known pain in the leg. Cortisone begins to make a more intense effect after 1 to 3 days. It is uncommon that pain relief does not occur.

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