J Korean Orthop Assoc.  2023 Apr;58(2):133-140. 10.4055/jkoa.2023.58.2.133 .

Clinical Outcomes of Ultrasound Guided Transforaminal Root Block in Cervical Spondylotic Radiculopathy Caused by Osteophytes

• Kwon YH
• Jang J
• Kim CS

• KMID: 2541468
• DOI: http://doi.org/10.4055/jkoa.2023.58.2.133

Abstract

Purpose
This study examined the follow-up progress and the usefulness of treating transforaminal nerve root block using ultrasound in patients with cervical radiculopathy caused by the osteophytes of spondylosis.
Materials and Methods
From January 2016 to January 2021, among 140 patients who presented with cervical radiculopathy, 73 who did not improve with conservative treatment were treated with an ultrasound-guided transforaminal nerve root block. The subjects comprised 46 confirmed cases of spondylotic radiculopathy caused by osteophytes and 27 cases of soft disc herniation. Surgical treatment was performed if the pain did not improve by more than 50% after a six-week follow-up. If 50% or more improvement was achieved, additional procedures were performed an extra two–three times at the patient’s discretion. The effectiveness of the procedure was examined by measuring the degree of pain and functional improvement before, after, and 12 weeks after the procedure. The safety of the procedure was evaluated by examining the side effects that occurred during, immediately after, and the day after the procedure. Additional procedures or surgeries were checked at the last follow-up of more than one year.
Results
Among patients with cervical spondylotic radiculopathy, the degree of pain decreased from 6.16 to 2.80. Nineteen patients (41.3%) showed symptom recurrence, and the average recurrence duration was 17.41 weeks. Five patients (10.9%) underwent anterior cervical discectomy and fusion. Until the final follow-up, 41 patients (89.1%) improved without surgery, and 24 (52.2%) received additional conservative treatment. Among soft intervertebral disc herniation, the degree of pain decreased from 6.31 to 2.79. Nine patients (33.3%) showed symptom recurrence, and the average recurrence duration was 11.65 weeks. One patient (3.7%) underwent anterior cervical discectomy and fusion.
Conclusion
In patients with cervical spondylotic radiculopathy caused by osteophytes, a transforaminal root block showed significant pain improvement similar to soft intervertebral disc herniation. Therefore, ultrasound-guided transforaminal root block can be considered a conservative treatment method for patients with cervical spondylotic radiculopathy caused by osteophytes.

Keyword

cervical vertebrae; osteophyte; radiculopathy; anesthesia epidural; ultrasonography interventional