Therapeutic selective nerve root block in the nonsurgical treatment of atraumatic cervical spondylotic radicular pain: A retrospective analysis with independent clinical review

2000 ◽  
Vol 81 (6) ◽  
pp. 741-746
Author(s):  
Curtis W. Slipman ◽  
Jason S. Lipetz ◽  
Howard B. Jackson ◽  
Denis P. Rogers ◽  
Edward J. Vresilovic
Keyword(s):  
Retrospective Analysis ◽  
Clinical Review ◽  
Nerve Root ◽  
Radicular Pain ◽  
Nonsurgical Treatment ◽  
Nerve Root Block ◽  
Selective Nerve Root Block

scholarly journals Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 635
Author(s):  
Seok Kang ◽  
Ha-Mok Jeong ◽  
Beom-Suk Kim ◽  
Joon-Shik Yoon
Keyword(s):  
Nerve Root ◽  
Injury Risk ◽  
Ultrasound Image ◽  
Radicular Pain ◽  
University Hospital ◽  
Cross Sectional ◽  
Long Thoracic Nerve ◽  
Nerve Root Block ◽  
Thoracic Nerve ◽  
Selective Nerve Root Block

Background and Objectives: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. Materials and Methods: This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. Results: The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm2 (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. Conclusion: Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN.

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