Effectiveness of Ultrasound-guided selective nerve block for chronic cervical radiculopathy

Ultrasound-guided selective nerve root block relieves symptoms associated with chronic cervical radiculopathy (also called as pinched nerve), potentially lowering the need for surgical intervention while offering real-time visualization and minimal radiation exposure.

To study the effectiveness of ultrasound-guided selective nerve root block (SNRB) for symptomatic relief and preventing surgical options in treating chronic cervical radiculopathy (CCR).

In this study, a retrospective analysis was done on 720 outpatients treated for CR. The patients with traumatic CR, malignancies, progressive neurological symptoms needing immediate surgery, prior surgeries, or inadequate response to conservative treatment were not considred for this analysis. Ultimately, 92 patients were included, experiencing radicular pain for over three months with no relief after 6 weeks of conservative therapy and VAS ≥ 5.

These patients underwent single or multiple ultrasound-guided SNRB procedures, taking Dexamethasone and Lidocaine injections guided by real-time ultrasound. Symptom severity was assessed at baseline and at 4, 8, and 12 weeks’ post-procedure using the VAS. Data collected included demographic details, pain characteristics, physical exam findings, symptom recurrence, symptom improvement, and the need for subsequent surgical intervention.

Results from the study showed significant symptom improvement in 75% of participants following SNRB. Specifically, 79.7% experienced improvement at 4 weeks, 15.9% at 8 weeks, and 4.4% at 12 weeks’ post-procedure.

Symptom recurrence (increase in VAS score with pain lasting at least 24 hours after a pain-free period of one month) occurred in 52.2% of patients. The presence of both neck and radicular pain significantly predicted recurrence. Symptom relief did not show significant correlations with gender, age, initial pain severity, or MRI results.

Ultrasound-guided SNRB has proven to be beneficial in treating CCR, alleviating symptoms and potentially diminishing the necessity for surgery.