Lumber Nerve Root Block
Lumbar nerve root block is the most effective treatment for low back pain / sciatic nerve pain / numbness / paralysis / intermittent claudication of lower limb etc etc. With the magnitude of the effect, there is nothing to the right of this injection, it is a large block injection under X-ray fluoroscopy. It can also be done for recurrence symptoms after performing lumbar spinal fusion surgery. And I have been collecting patients whose neuralgia has deteriorated after lumbar surgery and have been doing this for a long time to improve the standard of living in this block.
In general, however, it is considered to be a block injection “There are many risks in the nerve root block, except when the symptoms are so heavy.” I have studied techniques to reduce those risks on a daily basis. I thought about how to use medicines that will maximize the efficacy of the nerve root block. As a result, I did not make complications, made a record that dramatically improves the symptoms, and made the nerve root block casual.
However, it is dangerous to have a nerve root block of a physician whose skill is inexperienced. I will explain the reason.
The nerve root block is a procedure that directly sticks a thick needle of 25 G or more directly to the nerve. Therefore, the nerve is surely damaged. Most of the time nervousness does not get important because of its high regenerative ability. But the fact that it damages the nerve is inevitable. If they do not delicate, there is a possibility that aftereffects will occur.
They inject needles into the nerve and inject contrast media. Contrast agents are chemicals that are not completely safe for the body and are foreign matter. Because it puts it inside the nerve sheath, it deals somewhat damage to nerve tissue. The risk of inflammation to create aftereffects is not zero.
Piercing the nerve root with a needle risks damaging the nerve root artery. Should they embolize the root artery, the nerve may be necrotized.
It is forbidden to use a drug called Kenacort A (Triamcinolone Acetonide) for the nerve root block. The reason is that there is a report of an accident that Kenacort A is solid and injected by piercing the root artery, resulting in arterial embolism resulting in neuronal necrosis. Still, because Kenacort A has tremendous therapeutic effect, there are not many doctors using it
The pain of injection is not ordinary, in some cases it is a procedure that is so painful that it faints. If you hit a doctor who does not have pain relief techniques, you will see hell.
I do not agree to leave the nerve root block to a doctor who can not circumvent at least one of these risks.
The only way to avoid these risks is to “do without sticking the nerve roots”. I was given charge of the nerve root block at the third year of doctor, and experienced about 200 cases a year at that time, after that I tried to study the nerve root block technique. And “I will discover that the nerve root block does not stick directly to the nerve, even if only infiltrating the medicine around the nerve root, it has an effect, and in other cases, the treatment outcome is better.” From this point on I have been studying “a method of injecting directly into the nerve root without needling a needle”. I will advance the needle while using station narcotics and do not pierce the nerve directly so it feels pain only when stabbing the skin with a needle. I do not stab the nerve root. I do not stab the root artery. I do not put the contrast agent into the nerve sheath. Therefore, I hardly make complications.
Although it is a problem Kenacort A, I can use it because I will never stab the root artery. I am doing research on safe usage of Kenacort A at the same time and do not use reckless usage like other doctors. Therefore, “One-rank nerve root block using Kenacort A” has become possible. However, as doctors who use Kenacort A roughly make complications, the image “Doctors using Kenacort A” = “outlaws” is spreading.
In recent years, doctors doing nerve root blocking by a technique similar to myself began to appear. I learned that my method is called “resistance disappearance method”. The infusion pressure of injected medicine is low around the area where the injection needle crosses the facet joint. Insert injection solution at that point and do not stab the nerve root directly.
In order to do this method it is necessary that the sense of the needle point is trained. I have been conducting the resistance disappearance method 25 years ago.Nerve root blocks are usually done only three times in a row. That is because this technique is more likely to hurt nerve roots. If you do it many times in succession, the risk of aftereffects will increase. However, with the resistance disappearance method, no matter how many times we go through the block, it hardly causes nerve damage. Therefore I can patronize and treat patients with refractory lumbar spine disease patiently, and as a result I have been able to improve refractory diseases that are said to require surgery.
The nerve root block is so powerful a treatment that it has an effect on recurrent cases after spinal surgery. However, we do not recommend that you take this lightly because of serious risk.
But, in fact, if you are told by a doctor that “you should perform surgery at the waist”, you should definitely receive a nerve root block at least once. Because it may improve as much as there is no need for surgery. The proportion is about 90% in my clinic.
The nerve root block is the strongest. However, considering the risk, we do not recommend you to take anything other than the resistance loss method. It is strongly recommended to try the nerve root block by resistance loss method before surgery of the lumbar spine.