The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model

Beynon R, Hawkins J, Laing R, Higgins N, Whiting P, Jameson C, Sterne JA, Vergara P, Hollingworth W
Record ID 32011000653
Authors' objectives: This project aimed to: 1.Conduct a systematic review (SR) to determine the diagnostic performance of SNRB in patients with probable radicular pain that is not fully concordant with the imaging findings prior to lumbar decompression surgery. 2.Evaluate whether or not the diagnostic accuracy of SNRB varies by patient subgroup (e.g. patients with suspected radiculopathy at more than one level of the lumbar spine). 3.Conduct a SR to summarise the evidence on the incidence of procedure-related complications of diagnostic SNRB. 4.Conduct a SR of previous economic studies of the use of SNRB in patients with suspected LR and develop a cost-effectiveness model to evaluate the cost-effectiveness of using SNRB in patients with discordant clinical and imaging findings, including value of information analysis.
Authors' recommendations: Study found few studies that estimated the diagnostic accuracy of selective nerve root blocks (SNRBs) in patients with radiculopathy and all were limited by the difficulty of making a reference standard diagnosis. Based on current weak evidence, it is unlikely that SNRB is a cost-effective method for identifying the symptomatic nerve root prior to lumbar spine surgery.
Project Status: Completed
Year Published: 2013
URL for published report:
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Cost-Benefit Analysis
  • Lumbar Vertebrae
  • Models, Econometric
  • Nerve Block
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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Copyright: 2013 Queen's Printer and Controller of HMSO
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