DOI: https://doi.org/10.36347/sjams.2024.v12i09.011

Pages: 1178-1186

Background: Selective nerve root blocks or transforaminal epidural injections are commonly utilized for both diagnosing and treating various spinal disorders, such as radiculopathy or nerve compression. However, there is currently no clear consensus on their role as a diagnostic tool. The effectiveness of these injections in accurately diagnosing the underlying cause of spinal pain remains uncertain, as studies show mixed results regarding their diagnostic reliability. While these injections can provide temporary pain relief and may help identify the specific nerve root involved, their long-term diagnostic value is still a topic of debate. A systematic review of clinical studies was conducted to evaluate the accuracy of selective nerve root injections for diagnosing spinal pain. Methodological quality was assessed using the PRISMA guidelines. Studies were categorized based on the strength of evidence into five levels: problem identification, literature searching, data review and evaluation, data synthesis and analysis or data presentation. Studies were categorized based on the strength of evidence into five levels: conclusive, strong, moderate, limited, or indeterminate. The review included an extensive literature search across multiple databases such as PubMed, Google Scholar and EMBASE. There is limited evidence regarding the effectiveness of selective nerve root injections as a diagnostic tool for spinal pain. Although the research is insufficient to provide stronger support, the existing literature suggests that selective nerve root injections can be useful in diagnosing uncertain cases of radicular pain. Moderate evidence supports their use in preoperative evaluations, particularly when imaging studies are negative or inconclusive. While the positive predictive value of these injections is low, they are valuable for their negative predictive value, meaning they are more effective in ruling out conditions than in confirming them.