Abstract
OBJECTIVE: Ultrasound-guided cervical nerve root block (US-CRB) is considered a safe and effective method for the treatment of radicular pain. However, previous studies on the spreading pattern of injected solution in US-CRB have reported conflicting results. The aim of this study was to investigate the spreading pattern in relation to injection volume.
DESIGN: An institutional, prospective case series.
SETTING: A university hospital.
SUBJECTS: Fifty-three patients diagnosed with mono-radiculopathy in C5, 6, or 7.
METHODS: US-CRB with fluoroscopic confirmation was performed. After the cervical roots were identified in ultrasound imaging, a needle was gently introduced toward the posterior edge of the root using an in-plane approach. The spread of 1 mL and 4 mL contrast medium, each injected in the same needle position, was examined with anteroposterior and lateral fluoroscopic views. After contrast injection, a mixture of local anesthetic and corticosteroid was injected. Clinical outcome was assessed using a numeric rating scale before and 2 weeks after the procedure.
RESULTS: Contrast medium did not spread into the epidural space in any patients with 1 mL contrast medium injection, but it did spread into the intraforaminal epidural space in 13 patients (24.5%) with 4 mL. Pain improved in all patients. There was no significant difference in pain relief according to the spreading pattern.
CONCLUSION: The spreading pattern of injected solution in US-CRB could be partially affected by the injectant volume. However, further studies are needed to assess the importance of other factors, such as needle position and physiological effects.
| Original language | English |
|---|---|
| Pages (from-to) | 1978-1984 |
| Number of pages | 7 |
| Journal | Pain medicine (Malden, Mass.) |
| Volume | 17 |
| Issue number | 11 |
| Publication status | Published - 2016 Nov 1 |
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Keywords
- Cervical
- Radiculopathy
- Selective Nerve Root Injection
- Spreading Pattern
- Ultrasound
ASJC Scopus subject areas
- Clinical Neurology
- Anesthesiology and Pain Medicine
Cite this
Ultrasound-Guided Cervical Nerve Root Block : Does Volume Affect the Spreading Pattern? / Kang, Seok; Yang, Seung Nam; Kim, Se Hwa; Byun, Chan Woo; Yoon, Joon Shik.
In: Pain medicine (Malden, Mass.), Vol. 17, No. 11, 01.11.2016, p. 1978-1984.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ultrasound-Guided Cervical Nerve Root Block
T2 - Does Volume Affect the Spreading Pattern?
AU - Kang, Seok
AU - Yang, Seung Nam
AU - Kim, Se Hwa
AU - Byun, Chan Woo
AU - Yoon, Joon Shik
PY - 2016/11/1
Y1 - 2016/11/1
N2 - OBJECTIVE: Ultrasound-guided cervical nerve root block (US-CRB) is considered a safe and effective method for the treatment of radicular pain. However, previous studies on the spreading pattern of injected solution in US-CRB have reported conflicting results. The aim of this study was to investigate the spreading pattern in relation to injection volume.DESIGN: An institutional, prospective case series.SETTING: A university hospital.SUBJECTS: Fifty-three patients diagnosed with mono-radiculopathy in C5, 6, or 7.METHODS: US-CRB with fluoroscopic confirmation was performed. After the cervical roots were identified in ultrasound imaging, a needle was gently introduced toward the posterior edge of the root using an in-plane approach. The spread of 1 mL and 4 mL contrast medium, each injected in the same needle position, was examined with anteroposterior and lateral fluoroscopic views. After contrast injection, a mixture of local anesthetic and corticosteroid was injected. Clinical outcome was assessed using a numeric rating scale before and 2 weeks after the procedure.RESULTS: Contrast medium did not spread into the epidural space in any patients with 1 mL contrast medium injection, but it did spread into the intraforaminal epidural space in 13 patients (24.5%) with 4 mL. Pain improved in all patients. There was no significant difference in pain relief according to the spreading pattern.CONCLUSION: The spreading pattern of injected solution in US-CRB could be partially affected by the injectant volume. However, further studies are needed to assess the importance of other factors, such as needle position and physiological effects.
AB - OBJECTIVE: Ultrasound-guided cervical nerve root block (US-CRB) is considered a safe and effective method for the treatment of radicular pain. However, previous studies on the spreading pattern of injected solution in US-CRB have reported conflicting results. The aim of this study was to investigate the spreading pattern in relation to injection volume.DESIGN: An institutional, prospective case series.SETTING: A university hospital.SUBJECTS: Fifty-three patients diagnosed with mono-radiculopathy in C5, 6, or 7.METHODS: US-CRB with fluoroscopic confirmation was performed. After the cervical roots were identified in ultrasound imaging, a needle was gently introduced toward the posterior edge of the root using an in-plane approach. The spread of 1 mL and 4 mL contrast medium, each injected in the same needle position, was examined with anteroposterior and lateral fluoroscopic views. After contrast injection, a mixture of local anesthetic and corticosteroid was injected. Clinical outcome was assessed using a numeric rating scale before and 2 weeks after the procedure.RESULTS: Contrast medium did not spread into the epidural space in any patients with 1 mL contrast medium injection, but it did spread into the intraforaminal epidural space in 13 patients (24.5%) with 4 mL. Pain improved in all patients. There was no significant difference in pain relief according to the spreading pattern.CONCLUSION: The spreading pattern of injected solution in US-CRB could be partially affected by the injectant volume. However, further studies are needed to assess the importance of other factors, such as needle position and physiological effects.
KW - Cervical
KW - Radiculopathy
KW - Selective Nerve Root Injection
KW - Spreading Pattern
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85028246044&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028246044&partnerID=8YFLogxK
M3 - Article
C2 - 27009293
AN - SCOPUS:85028246044
VL - 17
SP - 1978
EP - 1984
JO - Pain Medicine
JF - Pain Medicine
SN - 1526-2375
IS - 11
ER -