Controversy. The use of selective nerve root blocks: diagnostic, therapeutic, or placebo?

An increasing number of therapeutic spinal injections are performed each year despite little validation in randomized controlled trials. Additional injections are performed for diagnostic purposes of localizing symptomatic nerve roots, again without detailed evaluation of accuracy, specificity, or sensitivity. Drs. Slosar and White argue that selective nerve root blocks are extremely useful; Dr Wetzel believes that selective nerve root blocks have no role in selecting patients for surgery.