Sacral Nerve Root Block



  • Selective corticosteroid and long-acting anesthetic injection of sacral nerve root at level of neural foramen


  • Malignant or benign neoplasm

  • Imaging

    • Evaluate relevant anatomic landmarks

    • Search for other causes of patient pain


  • Anchor 22-gauge spinal needle in subcutaneous tissue and confirm trajectory with fluoroscopy

    • Right side: Target foramen at 1-2 o'clock

    • Left side: Target foramen at 10-11 o'clock

  • Pain score

    • Note patient pain before, during, and after injection

    • Whether pain was reproduced during procedure

  • Alternatives

    • Caudal epidural steroid injection

    • Lumbar nerve root block

    • Sacroiliac injection


  • Expected

    • Reproduction of pain during injection

    • Significant relief of pain following injection

  • Problems

    • Extraforaminal injection failure of pain control/false-negative study

    • Diagnostic failure: Wrong level or selected root not sole pain generator

    • Nerve root injury, bleeding, infection

    • Vasovagal reaction

Preprocedure Imaging: 3D CT

Perineural Cysts

Foraminal Contrast Injection: AP View

Needle Placement Confirmed: Lateral View



  • Nerve root block (NRB)

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