Journal of neurosurgery. Spine
October 9, 2026 · via Europe PMC
Diagnostic selective nerve root block in degenerative lumbar spine radiculopathy: a systematic review and meta-analysis.
Kocemba D, Ørskov S, Carlsen JG, +5 more, Rasmussen MM
AI summary — for doctors, generated from the abstract only
Selective nerve root blocks had good sensitivity but only modest specificity for predicting surgical response in lumbar radiculopathy.
What was studied
A systematic review and meta-analysis of 25 studies (7 in meta-analysis) of fluoroscopy or CT-guided blocks in surgical patients, with QUADAS-2 and GRADE assessment.
Key findings
- Summary sensitivity was 0.88 (95% CI 0.80-0.92).
- Summary specificity was 0.57.
- Only 7 of 134 full-text studies were pooled.
Clinical relevance
Spine surgeons can use a positive block as supportive, not conclusive, evidence when levels are unclear.
Who should care
Limitations
Few studies in the pooled analysis, likely heterogeneous techniques, and the abstract is cut off before the specificity interval.
A negative block argues against surgery success, but a positive block should not alone justify it.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
OBJECTIVE
The aim of this study was to estimate the diagnostic accuracy of selective nerve root blocks (SNRBs) in patients with lumbar radiculopathy undergoing surgery.
METHODS
The authors searched major medical databases (PubMed, Embase, CINAHL [Cumulative Index to Nursing and Allied Health Literature], Cochrane Library, Web of Science, Google Scholar, and Scopus) and trial registries (ClinicalTrials.gov, ICTRP [International Clinical Trials Registry Program], CENTRAL [Cochrane Central Register of Controlled Trials]). They included studies that 1) investigated foraminal or transforaminal SNRB in adults with degenerative lumbar conditions and radiculopathy; 2) utilized local anesthetics, steroids, or both; 3) performed SNRB under fluoroscopic or CT guidance; and 4) reported SNRB response and postoperative outcomes. Two independent reviewers screened the studies, assessed the risk of bias using QUADAS (Quality Assessment of Diagnostic Accuracy Studies)-2, and evaluated the certainty of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Diagnostic accuracy was evaluated using a random-effects model to calculate summary estimates for sensitivity and specificity.
RESULTS
The authors identified 11,723 studies, of which 134 were selected for full-text review. Of these, 25 met the inclusion criteria for the systematic review and 7 for the meta-analysis. Summary estimates for sensitivity of 0.88 (95% CI 0.80-0.92) and specificity of 0.57 (95% CI 0.27-0.83), I2 = 24.7%, were obtained. The certainty of evidence was rated moderate for sensitivity and very low for specificity.
CONCLUSIONS
This is the first meta-analysis to evaluate the sensitivity, specificity, and certainty of evidence for SNRB. The diagnostic utility depends highly on the pretest probability of a favorable surgical outcome. Clinicians should interpret SNRB findings within the context of clinical and imaging findings.
DOI
10.3171/2026.4.SPINE251222
PMID
42854251
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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