Therapeutic selective nerve root block in the nonsurgical treatment of traumatically induced cervical spondylotic radicular pain.
OBJECTIVE
To investigate the outcomes resulting from the use of fluoroscopically guided therapeutic selective nerve root block in the nonsurgical treatment of traumatically induced cervical spondylotic radicular pain.


METHODS
Retrospective study with independent clinical review. A total of 15 patients who met specific physical examination or electrodiagnostic criteria and failed to improve clinically after at least 4 wks of physical therapy were included. Each patient demonstrated a positive response to a fluoroscopically guided cervical selective nerve root block. Therapeutic selective nerve root blocks were administered in conjunction with physical therapy. Outcome measures included visual analog scale pain scores, employment status, medication usage, and patient satisfaction.


RESULTS
Patients' symptom duration before diagnostic injection averaged 13.0 mos. An average of 3.7 therapeutic injections were administered. Follow-up data collection transpired at an average of 20.7 mos after discharge from treatment. An overall good or excellent outcome was observed in three patients (20.0%). Among those treated without surgery, a significant reduction (P = 0.0313) in pain score was observed at the time of follow-up. Six patients (40.0%) proceeded to surgery.


CONCLUSIONS
These initial and preliminary findings do not support the use of therapeutic selective nerve root block in the treatment of this challenging patient population with traumatically induced spondylotic radicular pain.
Slipman
Curtis W
CW
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Lipetz
Jason S
JS
DePalma
Michael J
MJ
Jackson
Howard B
HB
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D002574:Cervical Vertebrae / Q000293:injuries*; D004568:Electrodiagnosis; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005471:Fluoroscopy / Q000379:methods / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods* / Q000523:psychology; D010147:Pain Measurement; D017060:Patient Satisfaction; D010808:Physical Examination; D011843:Radiculopathy / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods / Q000523:psychology; D012189:Retrospective Studies; D013128:Spinal Osteophytosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013130:Spinal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014911:Whiplash Injuries / Q000150:complications
D000700:Analgesics