Dorsal root ganglion block

What is a dorsal root ganglion block?

This procedure called a dorsal root ganglion block is where a small amount of local anaesthetic with or without a steroid is injected on to a collection of nerve cells called the dorsal root ganglion which are located either side of the spine. This collection of nerves carry impulses from muscles and other parts of the body to the spinal cord and from there to the brain. When these nerves become inflammed (tissue response to irritation) they can give rise to pain.

Benefits

Performing a dorsal root ganglion block may help to alleviate the pain. If local anaesthesia with are without steroid provide temporary benefit, in selected patients, it is possible to do the procedure in a different way (pulsed radiofrequency treatment) with an objective to provide longer-lasting pain relief.

Risks

Unfortunately no procedure is risk free. There may be some temporary discomfort at the site of injection, infection and bruising. There is a possibility that you may have an allergic reaction to the drugs used. Less common side-effects include leg weakness and numbness of legs. Very rare side-effects include nerve-damage, spinal cord damage and infection resulting in permanent neurological problems.

Before the procedure

• You will have the treatment as a day case

• You can have a light early breakfast

• You should arrange for someone to drive you home after the procedure

• Although the procedure will be done in about 20 to 30 minutes, your stay may

vary between two to three hours

• Please bring a list of your current medications with you. If you are on medicines such as warfarin or clopidogrel please do inform the doctor. After liaising with the doctor, these blood thinning medicines need to be temporarily stopped prior to the procedure. If you were on warfarin you will have to undergo a blood test in the morning to ensure your blood clots normally.

• You will be asked to undress and put on a theatre gown ( you can leave your underwear on)

• Your doctor will discuss the procedure with you and ask you to sign a consent form. As the procedure involves the use of x-rays, female patients will be asked for the possibility of being pregnant.

The procedure

• The procedure is carried out under x-ray screening.

• Once you are in the correct position (lying on your front) the doctor will clean your back with an antiseptic solution which may feel cold

• A local anaesthetic will be injected at the site of the procedure. This may sting initially before the skin goes numb.

• It is important that you keep still during the procedure as the needle will be carefully inserted. When the injection takes place you may feel a pushing sensation or some discomfort. To confirm the position of the needle a contrast (a solution which shows up under x-ray) is injected.

• The local-anaesthetic and steroid will then be injected and a feeling of tightness may be felt. (for pulsed radio-frequency procedure, instead of injecting medicine, a strong electric field will be created using that needle. This can selectively modify pain transmission without causing permanent damage to the rest of the nerves)

• A small dressing will be placed over the needle insertion site. This can be removed in the evening

Following the procedure

• After the procedure you will be taken to an area to recover.

• You will be asked to lay on the trolley for a short period and the nursing staff will assist you to sit up

• The nursing staff will observe you before going home.

• Please be careful when you first get out of the trolley – ensure you are steady on your feet.

• Take your regular medication and pain killers as normal.

• There can be an initial exacerbation of discomfort before you start experiencing the pain relief. During this period, you may need to increase your pain killers or require stronger pain killers. Please see your GP or contact your doctor if current pain medicines are inadequate.

Please ensure that you have arranged for someone to drive you home after this procedure.

The information in this leaflet is not intended to replace your doctor's advice. If you require more information or have any questions, please speak to you doctor prior to the consent for the procedure.