• Reto Sutter, Christian W A Pfirrmann, Marco Zanetti, Juerg Hodler, and Cynthia K Peterson.
• Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008 Zürich, Switzerland. reto.sutter@balgrist.ch
• Skeletal Radiol. 2011 Dec 1; 40 (12): 1603-8.

ObjectiveTo 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.Materials And MethodsThe 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.ResultsFifty-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.ConclusionsThe 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.

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