RT Journal Article
SR Electronic
T1 Counterpoint: Conventional Fluoroscopy-Guided Selective Cervical Nerve Root Block—A Safe, Effective, and Efficient Modality in the Hands of an Experienced Proceduralist
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1112
OP 1119
DO 10.3174/ajnr.A6580
VO 41
IS 6
A1 F.W. Ott
A1 R. Pluhm
A1 K. Ozturk
A1 A.M. McKinney
A1 J.B. Rykken
YR 2020
UL http://www.ajnr.org/content/41/6/1112.abstract
AB BACKGROUND AND PURPOSE: The conventional fluoroscopy-guided (CF) selective cervical nerve root block (SCNRB) is being used commonly as a treatment for cervical radicular pain as well as a diagnostic tool. This study aimed to identify any major complications and determine the safety and clinical utility of CF-SCNRB performed in a university hospital and associated outpatient clinics.MATERIALS AND METHODS: Two-hundred fifty-four conventional fluoroscopy-guided selective cervical nerve root blocks were retrospectively identified from 2011 to 2018 using a radiology report search tool. Each procedure was performed by an experienced neuroradiologist performing spinal injections on a full-time basis in clinical practice. A 10-point pain scale was used for pre- and postprocedural pain-level assessment. Successful conventional, fluoroscopy-guided, selective cervical nerve root block was defined as a patient-reported pain scale reduction of at least 50% and/or alleviation of numbness or paresthesia at ≥2 weeks postinjection. All clinically important immediate and delayed complications were also recorded.RESULTS: Two-hundred fifty-four conventional fluoroscopy-guided selective cervical nerve root blocks were performed via an anterolateral approach with an average fluoroscopy time of 24.3 seconds for all cases. There were no aborted procedures and no major or permanent complications. There were 14 minor complications; 12 of these were periprocedural and resolved by the 2-week follow-up visit. One-hundred eighty-five patients (75.2%) reported pain improvement of >50% from baseline at 15 minutes postinjection. Overall, 172 patients (67.7%) reported >50% pain scale reduction or alleviation from paresthesia at least 2 weeks postinjection.CONCLUSIONS: Conventional fluoroscopy-guided selective cervical nerve root block is an efficacious, efficient, and safe outpatient procedure when performed by a skilled and experienced proceduralist.CFconventional fluoroscopyCT/FCT fluoroscopySCNRBselective cervical nerve root block