I'm going for a pain block procedure on levels l4-s1. what are risks of anesthesiologist doing a manipulation at the same time?

Pain block: Sounds like your are going to have an epidural of some type. Risk from epidural are bleeding resulting in epidural hematoma, spinal leak and infection. Hematoma primarily a problem with people on blood thinners. Leakage can be in the 5% range and infection is about .08%. I am not quite sure what manipulation you are having so I can not address that question.