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BJA Advance Access published online on June 25, 2009
British Journal of Anaesthesia, doi:10.1093/bja/aep166
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Bilateral L1 and L2 dorsal root ganglion blocks for discogenic low-back pain

J. Richardson1,*, N. Collinghan1, A. J. Scally2 and S. Gupta1

1 Department of Anaesthetics and Pain, Bradford Royal Infirmary, Bradford BD9 6RJ, UK
2 School of Health Studies, University of Bradford, Bradford, UK

* Corresponding author. E-mail: docjohnnyr{at}hotmail.com

Background: It is possible that interruption of nociceptive input from intervertebral discs can be modulated through bilateral L1 and L2 dorsal root ganglia (DRG) blockade. In order to test this hypothesis, we prospectively collected data from patients with low-lumbar pain, accurately diagnosed as discogenic using provocation discography.

Methods: Twelve patients were recruited with a mean (SD) symptom duration of 13.7 (8.2) years. Bilateral DRG blocks of L1 and L2 were performed using methylprednisolone 80 mg, clonidine 75 µg and 0.5% bupivacaine 4 ml in each patient.

Results: Analysis of Brief Pain Inventories showed no significant change in pain scores.

Conclusion: We conclude that blocks of this nociceptive pathway in humans using bilateral DRG blocks has no therapeutic value.

Keywords: anaesthetic techniques, regional; pain, chronic; pain, neurolysis; sympathetic nervous system, adrenergic block


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