Periradicular Therapy

Periradicular therapy (abbreviated: PRT) refers to the application of a strong anti-inflammatory drug locally to a nerve root (radix) as part of pain therapy for radiating (radicular) pain in proven diseases of the spine.

About the Treatment
The injected medication acts only on the damaged nerve root (epidural perineural injection). Typically, 1 to 3 sessions spaced 7 to 14 days apart lead to significant pain relief, even complete freedom from pain, in more than 80 percent of patients. The treatment is performed on an outpatient basis and takes approximately 15 minutes.

Indications:
Herniated disc, lumbar spinal stenosis (LSS), spondylolisthesis, and pain syndromes following spinal surgery (post-nucleotomy syndromes). In addition to back pain, the following typical radiating patterns and pain zones often occur:

L2 nerve root: groin
L3 nerve root: thigh
L4 nerve root: knee, shin
L5 nerve root: dorsum of the foot, big toe
S1 nerve root: calf, heel, and sole of the foot

Technique:
Patient lies prone. The spinal segment to be treated is visualized using computed tomography. Based on this, the injection direction and depth are planned. After skin disinfection, the sterile injection needle (coaxial interventional cannula) is precisely positioned. CT scan confirms the needle’s position using contrast medium, after which the medication (high-dose corticosteroid) is administered. In rare cases (<5%), headaches may occur after the PRT injection as a result of cerebrospinal fluid puncture. Despite damage to the spine or intervertebral disc, the patient can live, work, and participate in sports pain-free. A risky surgical procedure is usually avoided.