Nerve Root Block

Your referring physician has requested that you have a nerve root block. The following is a description of the procedure and potential complications, so that you may provide informed consent prior to the procedure. 

A nerve root block is an invasive procedure with some uncommon risks. After local anesthesia (numbing medicine) is injected, a needle will be placed with fluoroscopic (x-ray) guidance along your irritated nerve root. Occasionally, CT (or “CAT scan”) guidance may be used to help with needle placement. A small amount of contrast (x-ray dye) may be injected to help confirm the position of the needle. Typically a mixture of an anesthetic (numbing medicine) and a steroid will then be injected. Since we will be positioning the needle along your already irritated nerve, often you will experience brief pain along your typical area of pain either during needle positioning or during the injection of medication. Most complications of nerve root blocks are uncommon and the procedure is very safe. You need to know the potential complications, which include: 

1. BLEEDING: As with all needle procedures, bleeding can occur. As long as you have no bleeding tendency and are not on any blood-thinners such as Coumadin or Plavix, bleeding complications are extremely rare. Rarely, patients have had to undergo emergency surgery to relieve pressure on the nerve roots and spinal cord because of bleeding after needle procedures like nerve root blocks. 
2. INFECTION: Any needle through the skin can introduce infection. Infection is a rare complication, and sterile technique will be used to minimize the risk.
3. MUSCLE WEAKNESS/NUMBNESS OR BACK PAIN: Often you will experience numbness along the area supplied by your irritated nerve. This numbness typically lasts less than 3 hours, but may uncommonly last up to 24 hours. If this nerve supplies a muscle, it may cause weakness in that muscle. This weakness should be transient, probably only lasting 1 to 3 hours or so. If this nerve becomes irritated, it may result in transient back pain or temporarily worsen your normal pain. 
4. STEROID SIDE EFFECTS: Steroids injected at nerve roots may rarely produce unwanted side effects. Some of these potential side effects include increased blood sugar or hyperglycemia (especially in diabetic patients), fluid retention, elevated blood pressure, and transient redness or facial flushing. (Side effects from steroids are more common if they are taken daily over a length of time, rather than as an isolated nerve root injection.) 
5. ALLERGIC REACTION: The use of any medication, including x-ray contrast, has the possibility of producing an allergic reaction. Please inform your physician of your known medical allergies before the procedure. 

Please feel free to ask any questions you may have about the procedure prior to signing the consent form.