title: A simple, 10-minute procedure for transforaminal injection under ultrasonic guidance to effect cervical selective nerve root block.
abstract: The aim is to provide a detailed procedure of a simple and 10-minute cervical nerve root block (CNRB) under ultrasonic guidance, and to report the clinical outcomes, disorders, and complications. Records of patients who had undergone CNRB, were reviewed under ultrasonic guidance at the hospital from 2010 through 2012. The procedure is described in detail. Arm and shoulder pain was evaluated by use of the visual analogue scale (VAS). Forty-three patients agreed to undergo CNRB under ultrasonic guidance. Nerve roots from C5 to C8 were affected in 41, and these nerve roots were readily distinguished. Two of the 43 participants did not receive injections because impediments in visualizing the affected nerve root. Of the 41 who received injections, radicular pain immediately disappeared in 39, who continued to feel pain relief 1 month later. However, pain recurred in 15 patients (38%), of whom 11 underwent cervical spine surgery. The rest of 24 patients felt sustained pain relief longer than 3 months after the injection, significantly. Although one patient had recurrent radicular pain 10 months later, the pain could be controlled by medication. At the final follow-up periods, 17.2 (10-24 months), the median VAS score of the patients, 23 (0 to 71 mm), was significantly improvement (P = 0.001) in comparison to before injection 88 (range; 56-100). No complications occurred. The cervical nerve root block under ultrasonic guidance simply, safely, and efficaciously decreased radicular pain for 17.2 months in 62% patients with intolerable radicular pain.
authors.affiliation: Department of Spine Center, Aichi Medical University Hospital.
authors.forename: Mikinobu
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kamiya
authors.forename: Norimitsu
authors.initials: N
authors.lastname: Wakao
authors.forename: Koji
authors.initials: K
authors.lastname: Osuka
authors.forename: Muneyoshi
authors.initials: M
authors.lastname: Yasuda
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Terasawa
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yamada
authors.forename: Masakazu
authors.initials: M
authors.lastname: Takayasu
mesh_terms: D000328:Adult; D066008:Cervical Plexus Block / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D007278:Injections, Spinal / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011843:Radiculopathy / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013126:Spinal Nerve Roots / Q000187:drug effects*; D018084:Ultrasonography, Interventional / Q000295:instrumentation* / Q000379:methods*