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

Abstract

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. © The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved.