Chang Min Cheol, Boudier-Revéret Mathieu, Hsiao Ming-Yen, Shyu Shaw-Gang
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.
Department of Physical Medicine and Rehabilitation, University of Montreal Health Centre, Montreal, Canada.
J Int Med Res. 2020 Nov;48(11):300060520969538. doi: 10.1177/0300060520969538.
In clinical practice, neck pain is one of the most common complaints. Although most of the cervical radicular pain is manifested in the neck and upper extremities, C3 or C4 radicular pain only results in neck pain. It does not produce upper extremity radiating pain. This case report describes a 70-year-old male that presented with a numeric rating scale score of 5 out of 10 for the left neck pain that he had been experiencing for the previous 1 month. Hyperalgesia was present on the left C3 dermatome. Foraminal stenosis at the left C2-C3 was observed on cervical magnetic resonance imaging. In order to manage the neck pain on the left side due to the foraminal stenosis at the left C2-C3, a transforaminal epidural steroid injection (TFESI) was undertaken on the left C3 nerve root. Thirty minutes after TFESI, the patient's neck pain had completely resolved. At the 1-month and 3-month follow-ups, no neck pain was evident. Clinicians should consider the possibility of C3 radicular pain as a cause of neck pain, especially when the neck pain presents as neuropathic pain combined with sensory deficits.
在临床实践中,颈部疼痛是最常见的主诉之一。虽然大多数颈椎神经根性疼痛表现为颈部和上肢疼痛,但C3或C4神经根性疼痛仅导致颈部疼痛,不会产生上肢放射性疼痛。本病例报告描述了一名70岁男性,他在过去1个月中一直经历左侧颈部疼痛,数字评分量表评分为5分(满分10分)。左侧C3皮节存在痛觉过敏。颈椎磁共振成像显示左侧C2-C3椎间孔狭窄。为了治疗因左侧C2-C3椎间孔狭窄引起的左侧颈部疼痛,对左侧C3神经根进行了经椎间孔硬膜外类固醇注射(TFESI)。TFESI后30分钟,患者的颈部疼痛完全缓解。在1个月和3个月的随访中,无明显颈部疼痛。临床医生应考虑C3神经根性疼痛作为颈部疼痛原因的可能性,尤其是当颈部疼痛表现为神经性疼痛并伴有感觉缺陷时。