Blockade of the Sinuvertebral Nerve for the Diagnosis of Lumbar Diskogenic Pain: An Exploratory Study

Anesthesia and Analgesia June 3, 2010
Juerg Schliessbach, MD*, Andreas Siegenthaler, MD*, Paul Heini, MD†, Nikolai Bogduk, MD‡ and Michele Curatolo, MD*
+ Author Affiliations

From the *Department of Anesthesiology and Pain Therapy, and the †Department of Orthopedic Surgery, Inselspital Bern, Bern, Switzerland, and the ‡Department of Clinical Research, Royal Newcastle Centre, Australia.

Address correspondence to Juerg Schliessbach, Department of Anesthesiology and Pain Therapy, Inselspital Bern, Bern, Switzerland. Address e-mail to juerg.schliessbach@insel.ch.

•Paul Heini, MD, is currently affiliated with Sonnenhof Clinic, Bern, Switzerland.



Abstract

In this exploratory study we evaluated sensitivity and target specificity of sinuvertebral nerve block (SVNB) for the diagnosis of lumbar diskogenic pain. Diskography has been the diagnostic gold standard. Fifteen patients with positive diskography underwent SVNB via interlaminar approach to the posterior aspect of the disk. Success was defined as ≥80% pain reduction or excellent relief of physical restrictions after the block. The sensitivity was 73.3% (95% CI: 50.9%–95.7%). The target specificity was 40% (15.2%–64.8%). The results indicate that SVNB cannot yet replace diskography but encourage future studies to improve its target specificity.



Footnotes

The trial was funded by the research fund of the Department of Anesthesiology and Pain Therapy, Inselspital Bern, Bern, Switzerland.

Accepted March 9, 2010.