title: CT-guided cervical nerve root injections: comparing the immediate post-injection anesthetic-related effects of the transforaminal injection with a new indirect technique.
abstract: OBJECTIVE
  To describe an "indirect" cervical nerve root injection technique with a dorsal approach that should carry less inherent risk than the "direct" cervical transforaminal injection approach, and to compare the immediate post-injection results of the two procedures.
  
  
  METHODS
  The indirect and direct cervical nerve root injection procedures are described in detail. Fifty-three consecutive patients receiving the indirect nerve root injections during 2009-2010 were age- and gender-matched to 53 patients who underwent direct transforaminal nerve root injections performed in 2006. Pain level data were collected immediately before and 20-30 min after each procedure. The percentages of pain change in the two groups were compared using the unpaired Student's t test.
  
  
  RESULTS
  Fifty-two men (mean age 49) and 54 women (mean age 55) were included. The mean percentage of pain reduction for patients receiving indirect nerve root injections was 38.4% and for those undergoing the direct nerve root injections approach it was 43.2%. This was not significantly different (P = 0.455). No immediate or late adverse effects were reported after either injection procedure.
  
  
  CONCLUSIONS
  The indirect cervical nerve root injection procedure is a potentially safer alternative to direct cervical transforaminal nerve root injections. The short-term pain reduction is similar using the two injection methods.
authors.affiliation: Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008 Zürich, Switzerland. reto.sutter@balgrist.ch
authors.forename: Reto
authors.initials: R
authors.lastname: Sutter
authors.forename: Christian W A
authors.initials: CW
authors.lastname: Pfirrmann
authors.forename: Marco
authors.initials: M
authors.lastname: Zanetti
authors.forename: Juerg
authors.initials: J
authors.lastname: Hodler
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Peterson
mesh_terms: D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013126:Spinal Nerve Roots; D014057:Tomography, X-Ray Computed