J Korean Neurosurg Soc.  2010 Nov;48(5):419-422. 10.3340/jkns.2010.48.5.419.

Computed Tomography Fluoroscopy-Guided Selective Nerve Root Block for Acute Cervical Disc Herniation

• Eun SS
• Chang WS
• Bae SJ
• Lee SH
• Lee DY

• KMID: 1453316
• DOI: http://doi.org/10.3340/jkns.2010.48.5.419

Abstract

OBJECTIVE
To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective nerve root block (SNRB) for severe arm pain caused by acute cervical disc herniation.
METHODS
The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded.
RESULTS
The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion.
CONCLUSION
CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.

Keyword

Cervical vertebrae; Intervertebral disc; Nerve block

MeSH Terms

Arm
Cervical Vertebrae
Diskectomy
Female
Follow-Up Studies
Humans
Intervertebral Disc
Male
Nerve Block