J Korean Pain Soc.  2000 Nov;13(2):247-250.

L2 Root Block in Failed Back Surgery Syndrome

• Han SM
• Kim TH
• Lim YJ
• Lee SC

Abstract

Recently, some authors reported that discogenic low back pain should be regarded as a referred pain in respect of neural pathway. The afferent pathways of discogenic low back pain is transmitted mainly by sympathetic afferent fibres from the sinuvertebral nerves in the second lumbar nerve root. This pain arises from the lumbar intervertebral discs, and it had been transmitted mainly through the sympathetic afferent fibres contained in the second lumbar spinal nerve root. Second lumbar dermatome corresponds to the low back area. We experienced a case of low back pain which could not be controlled by conventional therapy and progressed wax and wane. The CT finding showed bulging disc between L4 and L5 and spinal stenosis in L4 area. And epiduroscopic feature showed severe adhesion in L4, L5 and S1. After we blocked L2 root, pain score decreased 10 to 2. Therefore, the L2 root block may be a useful diagnostic procedure as well as provide therapeutic value.

Keyword

Nerve block; Pain backpain; Spinal cord anatomy; Sympathetic Nervous System blockade

MeSH Terms

Afferent Pathways
Failed Back Surgery Syndrome*
Intervertebral Disc
Low Back Pain
Nerve Block
Neural Pathways
Pain, Referred
Spinal Nerve Roots
Spinal Stenosis