• Seok Kang, Seung Nam Yang, Se Hwa Kim, Chan Woo Byun, and Joon Shik Yoon.
• Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, Korea.
• Pain Med. 2016 Nov 1; 17 (11): 1978-1984.

ObjectiveUltrasound-guided cervical nerve root block (US-CRB) is considered a safe and effective method for the treatment of radicular pain. However, previous studies on the spreading pattern of injected solution in US-CRB have reported conflicting results. The aim of this study was to investigate the spreading pattern in relation to injection volume.DesignAn institutional, prospective case series.SettingA university hospital.SubjectsFifty-three patients diagnosed with mono-radiculopathy in C5, 6, or 7.MethodsUS-CRB with fluoroscopic confirmation was performed. After the cervical roots were identified in ultrasound imaging, a needle was gently introduced toward the posterior edge of the root using an in-plane approach. The spread of 1 mL and 4 mL contrast medium, each injected in the same needle position, was examined with anteroposterior and lateral fluoroscopic views. After contrast injection, a mixture of local anesthetic and corticosteroid was injected. Clinical outcome was assessed using a numeric rating scale before and 2 weeks after the procedure.ResultsContrast medium did not spread into the epidural space in any patients with 1 mL contrast medium injection, but it did spread into the intraforaminal epidural space in 13 patients (24.5%) with 4 mL. Pain improved in all patients. There was no significant difference in pain relief according to the spreading pattern.ConclusionThe spreading pattern of injected solution in US-CRB could be partially affected by the injectant volume. However, further studies are needed to assess the importance of other factors, such as needle position and physiological effects.© 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

25 keywords...

hide…