title: Long Term Outcomes from CT-guided Indirect Cervical Nerve Root Blocks and their relationship to the MRI findings--A prospective Study.
abstract: OBJECTIVE
  To investigate long-term pain reduction and 'improvement' in patients with indirect cervical nerve-root-blocks in comparison to MRI findings.
  
  
  METHODS
  One hundred and twelve patients with MRI confirmed cervical radiculopathy and an indirect cervical nerve-root-block were included. Two radiologists independently evaluated the MRI examinations. 12 different MRI abnormalities at the level and side of infiltration were compared to pain relief and 'improvement' at 1-month, 3-months and 1-year post injection.
  
  
  RESULTS
  The proportion of patients reporting clinically relevant 'improvement' was 36.7% at 1-month, 53.9% at 3-months and 68.1% at 1-year. At 1-month post injection, a statistically significantly lower percentage of patients eventually requiring surgery reported improvement and lower NRS change scores compared to those who did not undergo surgery (p = 0.001). Patients with extrusion of the disc were around 4-times more likely to have surgery. At 1-year post-injection the presence of nerve-root compromise was significantly linked to treatment outcome (p = 0.011).
  
  
  CONCLUSIONS
  Patients with nerve root compression were more likely to report improvement at 1 year. Patients with disc extrusions have less pain relief and are 4 times more likely to go to surgery than patients with disc protrusions.
  
  
  CONCLUSIONS
  • Good long term outcomes after indirect nerve root infiltrations with non-particulate steroids. • The presence of nerve root compression was a predictive finding of 'improvement'. • Significantly less patients subsequently having surgery had lower NRS scores 1-month post injection. • There is less pain relief in patients with disc extrusions. • There are less improvement in patients with modic type I changes.
authors.affiliation: Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland. susanne.bensler@balgrist.ch.|Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland. susanne.bensler@balgrist.ch.
authors.forename: Susanne
authors.initials: S
authors.lastname: Bensler
authors.affiliation: Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland. reto.sutter@balgrist.ch.|Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland. reto.sutter@balgrist.ch.
authors.forename: Reto
authors.initials: R
authors.lastname: Sutter
authors.affiliation: Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland. christian.pfirrmann@balgrist.ch.|Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland. christian.pfirrmann@balgrist.ch.
authors.forename: Christian W A
authors.initials: CW
authors.lastname: Pfirrmann
authors.affiliation: Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland. cynthia.peterson@balgrist.ch.|Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland. cynthia.peterson@balgrist.ch.
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Peterson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000517:prevention & control*; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D011843:Radiculopathy / Q000150:complications / Q000628:therapy*; D015641:Radiography, Interventional; D013126:Spinal Nerve Roots; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: CT guided; Cervical nerve root block; Indirect; Long term outcome; MRI