Department of Pain Management Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Pain Med. 2021 Sep 8;22(9):1940-1945. doi: 10.1093/pm/pnab008.
The aim of the present study was to investigate the effectiveness and safety of a novel lateral in-plane approach for ultrasound-guided transforaminal cervical nerve root block (US-guided TF-CNRB) in the treatment of cervical radiculopathic pain.
The design of the present study consisted of an institutional, retrospective case series.
The present study was conducted at a university hospital.
Thirty-two patients with cervical radiculopathy who were resistant to conservative therapies and regular US-guided CNRB were included as participants.
The included patients were treated with US-guided TF-CNRB. During the treatments, using real-time fluoroscopy, we monitored the spreading patterns of a contrast medium and double confirmed the positions of needle tips. Pain numeric rating scales (NRS) and symptom relief grades were determined via telephone interviews at one, four, and 12 weeks after the procedures.
US-guided TF-CNRB was performed at the C5 level in six patients, the C6 level in 18 patients, and the C7 level in eight patients. Compared with NRS at baseline, pain scores decreased throughout the observation period. Symptom relief rates of US-guided TF-CNRB at one, four, and 12 weeks were 72%, 69%, and 63%, respectively. Venous blood was aspirated during the procedures in two patients, and the needle tips were corrected. No intravascular injections or neurologic injuries were observed.
US-guided TF-CNRB produced circumferential spreading around the involved cervical nerve root and showed significant clinical effectiveness in patients resistant to regular US-guided CNRB.
本研究旨在探讨新型侧入路经皮椎间孔颈椎神经根阻滞（US 引导 TF-CNRB）治疗颈椎神经根病性疼痛的有效性和安全性。
本研究的设计为机构回顾性病例系列。
本研究在一家大学医院进行。
32 例对保守治疗和常规 US 引导 CNRB 无反应的颈椎神经根病患者入选为研究对象。
纳入的患者接受 US 引导 TF-CNRB 治疗。在治疗过程中，我们使用实时透视监测造影剂的扩散模式，并对针尖位置进行双重确认。在治疗后 1、4 和 12 周通过电话访谈确定疼痛数字评分量表（NRS）和症状缓解等级。
6 例患者在 C5 水平、18 例患者在 C6 水平和 8 例患者在 C7 水平进行了 US 引导 TF-CNRB。与基线 NRS 相比，疼痛评分在整个观察期内均降低。US 引导 TF-CNRB 在治疗后 1、4 和 12 周的症状缓解率分别为 72%、69%和 63%。在 2 例患者的治疗过程中抽吸到静脉血，对针尖进行了校正。未观察到血管内注射或神经损伤。
US 引导 TF-CNRB 可在受累颈椎神经根周围产生环形扩散，并对常规 US 引导 CNRB 无反应的患者具有显著的临床疗效。
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