scholarly journals Treatment Effects of Ultrasound Guide Selective Nerve Root Block for Lower Cervical Radicular Pain: A Retrospective Study of 1-Year Follow-up

2013 ◽  
Vol 37 (5) ◽  
pp. 658 ◽  
Author(s):  
Yongbum Park ◽  
Jae Ki Ahn ◽  
Yukyung Sohn ◽  
Haemi Jee ◽  
Ji Hae Lee ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Nerve Root ◽  
Treatment Effects ◽  
Radicular Pain ◽  
Nerve Root Block ◽  
Ultrasound Guide ◽  
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.

scholarly journals Clinical Outcomes of Posterior Percutaneous Endoscopic Cervical Foraminotomy and Discectomy Assisted with SNRB in Treating Cervical Radiculopathy with Diagnostic Uncertainty

2021 ◽  
pp. E483-E492
Keyword(s):  
Clinical Outcomes ◽  
Nerve Root ◽  
Cervical Radiculopathy ◽  
Radicular Pain ◽  
Diagnostic Uncertainty ◽  
Retrospective Design ◽  
The Mean ◽  
Selective Nerve Root Block ◽  
Cervical Foraminotomy

BACKGROUND: Selective nerve root block (SNRB) has been used to facilitate the diagnostic process when radiologic abnormalities are not correlated with clinical symptomatology in patients with cervical radiculopathy. Meanwhile, minimally invasive posterior percutaneous endoscopic cervical foraminotomy and discectomy (PPECFD) has been widely used to treat cervical radiculopathy because of its advantages. However, combination of these 2 procedures in the treatment of cervical radiculopathy with diagnostic uncertainty has not been reported. OBJECTIVES: To examine the clinical outcomes of PPECFD assisted with SNRB in patients who had cervical radiculopathy with diagnostic uncertainty. STUDY DESIGN: A retrospective design was used. SETTING: This study was conducted in a university-affiliated tertiary hospital in Shanghai, China. METHODS: Thirty consecutive patients with cervical radicular pain who had diagnostic uncertainty were included (January 2018 to January 2019). Diagnostic SNRB was performed to identify the responsible nerve root(s). PPECFD was selected as the treatment when the SNRB result was positive. Clinical outcomes were assessed by the Visual Analog Scale (VAS), Neck Disability Index (NDI), and modified Macnab criteria. Pre- and post-operative radiologic and clinical parameters were evaluated. Other information was retrieved from the electronic records. RESULTS: All patients had successful SNRB procedures. Four were excluded from the analysis because of the negative results of the SNRB. Among the remaining 26 patients who underwent the subsequent PPECFD surgery, the mean follow-up was 14 months. Compared with preoperative values, the mean VAS scores for radicular arm pain and neck pain, as well as the NDI score, improved significantly. According to the Macnab criteria, 22 patients (84.6%) had excellent or good results. No major peri- and postoperative complications were observed. LIMITATIONS: This study used a retrospective design with relatively small sample size and medium follow-up duration. CONCLUSIONS: Diagnostic SNRB may be a helpful tool to identify the origin of cervical radicular pain for patients with diagnostic uncertainty. With the guidance of SNRB, PPECFD is likely to be an effective and safe option for the treatment of cervical radiculopathy with diagnostic uncertainty. KEY WORDS: Cervical radiculopathy, selective nerve root block, percutaneous endoscopic cervical foraminotomy and discectomy, diagnostic, uncertainty

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