• Morsi Khashan, Jesus de Santiago, Itai Pardo, Gilad Regev, Dror Ophir, Khalil Salame, Zvi Lidar, Silviu Brill, and Uri Hochberg.
• Spine Surgery Unit, Neurosurgical Department, Tel Aviv Medical Center, Tel Aviv, Israel.
• Spine. 2022 Oct 1; 47 (19): 1351-1356.

Study Design And ObjectiveCervical radiculopathy is a common clinical condition, often treated with cervical epidural steroid injections (ESI). Retro-laminar cervical blocks (RLCB) may be considered safer than ESI as they do not require entering the neuroaxis.In this study, we evaluated the outcome of RLCB in patients with cervical radiculopathy who had failed conservative treatment and were candidates for cervical spine decompression surgery.Background DataRecently, we reported a clinical pilot study investigating the treatment of cervical radiculopathy with an ultrasound-guided RLCB.Materials And MethodsA retrospective, comparative analysis of prospectively collected data was carried out on the medical records of all patients who underwent RLCB for cervical radicular pain, between August 2019 and March 2021.ResultsNinety-eight patients were included in the analysis, with a total of 139 procedures.A significant pain reduction was achieved for most patients immediately after the procedure and at the final follow up (16.9±13.4 wk). The mean numerical rating scale for the whole cohort changed from 7.21±2.51 to 4.04±2.51 ( P -value <0.01) at the time of discharge, with similar patterns at the subgroup level. A functional evaluation was carried out by a questionnaire (Neck Disability Index-NDI). Overall, 83% of patients had a lower postprocedural NDI than preprocedural NDI. For 80% of patients, the improvement of NDI surpassed the minimal clinically important change at the final assessment. Most patients (61%) were discharged after just one RLCB. Eight patients (8%) eventually underwent surgery. The most frequent complaint was injection site soreness; however, there were no major adverse events reported.ConclusionsThese findings suggest that RLCB can be performed as an alternative to cervical ESI and decompressive surgery in patients with cervical radicular pain that's refractory to noninvasive treatment. More comparative and prospective studies are needed to confirm our results.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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