Immediate complications and pain relief associated with 296 fluoroscopically guided thoracic foraminal nerve blocks

The goal of this work is to review the thoracic foraminal nerve blocks and foraminal epidurals performed at a single institution to determine the incidence and types of immediate complications and pain relief associated with thoracic foraminal nerve blocks.

This retrospective study entailed a comprehensive review of the radiographs and reports of 296 injections performed in 225 examinations on 153 patients (60 men and 93 women). The overall mean age was 51.93 years (mean age for men, 50.71 years [range, 22-85 years]; mean age for women, 53.09 years [range, 18-84 years]). The data were later analyzed with contingency tables and chi-square tests.

The overall complication rate was 4.1% (12/296). Complication rates at the different needle tip positions measured on frontal and lateral fluoroscopic views did not approach statistical significance (p = 0.15). Complications were higher with cephalocaudal flow outside local flow (p = 0.02). No serious complications occurred except for one pneumothorax, which could have been avoided. Immediate partial or complete pain relief was obtained in 88.5% (262/296) of the injections and 88.4% (199/225) of the examinations.

Fluoroscopically guided thoracic foraminal nerve blocks are safe procedures and provide immediate partial or complete pain relief in a high percentage of patients.