Ultrasound-Guided Cervical Nerve Root Block: Does Volume Affect the Spreading Pattern?

Seok Kang, Seung Nam Yang, Se Hwa Kim, Chan Woo Byun, Joon Shik Yoon

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 languageEnglish
Pages (from-to)1978-1984
Number of pages7
JournalPain medicine (Malden, Mass.)
Volume17
Issue number11
Publication statusPublished - 2016 Nov 1

Fingerprint

Nerve Block
Contrast Media
Needles
Epidural Space
Pain
Injections
Radiculopathy
Local Anesthetics
Ultrasonography
Adrenal Cortex Hormones
Therapeutics

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 journalArticle

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