@article {Wolter1831, author = {T. Wolter and S. Knoeller and A. Berlis and C. Hader}, title = {CT-Guided Cervical Selective Nerve Root Block with a Dorsal Approach}, volume = {31}, number = {10}, pages = {1831--1836}, year = {2010}, doi = {10.3174/ajnr.A2230}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND AND PURPOSE: Cervical transforaminal blocks are frequently performed to treat cervical radicular pain. These blocks are performed mostly under fluoroscopy, but a CT-guided technique has also been described. The aim of this study was to review the results of CT-guided CSNRB by using a dorsal approach, to describe the contrast patterns achieved with this injection technique, and to estimate the degree of specificity and sensitivity. MATERIALS AND METHODS: We used a CT-guided technique with a dorsal approach leading to a more extra-than transforaminal but a selective nerve root block as well. Of 53 blocks, we performed 38 for diagnostic and 15 for therapeutic indications. Pain relief was measured hourly on a VAS. The distribution of contrast and the angle of the trajectory of the injection needle were analyzed as well as the degree of pain relief. RESULTS: Contrast was found in the intraforaminal region in 8 (15\%) blocks, extraforaminally in 40 (78\%) blocks, and intraspinally in 3 (6\%) blocks. The mean angle between the needle and the sagittal plane was 26.6{\textdegree} (range, from 1{\textdegree} to 50{\textdegree}). The mean distance between needle tip and nerve root was 4.43 mm (range, 0{\textendash}20 mm). Twenty-six (68.4\%) of the 38 diagnostic blocks led to a decrease in the pain rating of \>50\%. There were no complications or unintended side effects, apart from occasional local puncture pain. CONCLUSIONS: We conclude that CT-guided CSNRBs using a dorsal approach are feasible and that they are sensitive and specific. CSNRBcervical selective nerve root blockVASVisual Analog Scale}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/31/10/1831}, eprint = {https://www.ajnr.org/content/31/10/1831.full.pdf}, journal = {American Journal of Neuroradiology} }