Nerve Root Block
It is an option to treat patients who present with an osteoporotic spinal compression fracture at L3 or L4 on imaging with correlating clinical signs and symptoms suggesting an acute injury and who are neurologically intact with an L2 nerve root block.
LIMITED RECOMMENDATION Rationale
The role of L2 selective nerve root blocks as a non-operative treatment for back pain associated with mid-lumbar compression fracture has been studied.66 In this trial, two groups of 30 acute fracture patients received unilateral L2 root block or subcutaneous injection as a control. A possibly clinically important benefit was seen with the treatment at two weeks but became nonsignificant at one month. The effect of bilateral L2 injection was not addressed in this study or the literature. Based on this single study, support for L2 root injection for treating new onset back pain associated with L3 or L4 compression fractures is weak and is therefore only an option for temporary pain relief.