PMID- 27009293
OWN - NLM
STAT- MEDLINE
DCOM- 20170921
LR  - 20220331
IS  - 1526-4637 (Electronic)
IS  - 1526-2375 (Linking)
VI  - 17
IP  - 11
DP  - 2016 Nov
TI  - Ultrasound-Guided Cervical Nerve Root Block: Does Volume Affect the Spreading 
      Pattern?
PG  - 1978-1984
AB  - OBJECTIVE: Ultrasound-guided cervical nerve root block (US-CRB) is considered a 
      safe and effective method for the treatment of radicular pain. However, previous 
      studies on the spreading pattern of injected solution in US-CRB have reported 
      conflicting results. The aim of this study was to investigate the spreading 
      pattern in relation to injection volume. DESIGN: An institutional, prospective 
      case series. SETTING: A university hospital. SUBJECTS: Fifty-three patients 
      diagnosed with mono-radiculopathy in C5, 6, or 7. METHODS: US-CRB with 
      fluoroscopic confirmation was performed. After the cervical roots were identified 
      in ultrasound imaging, a needle was gently introduced toward the posterior edge 
      of the root using an in-plane approach. The spread of 1 mL and 4 mL contrast 
      medium, each injected in the same needle position, was examined with 
      anteroposterior and lateral fluoroscopic views. After contrast injection, a 
      mixture of local anesthetic and corticosteroid was injected. Clinical outcome was 
      assessed using a numeric rating scale before and 2 weeks after the procedure. 
      RESULTS: Contrast medium did not spread into the epidural space in any patients 
      with 1 mL contrast medium injection, but it did spread into the intraforaminal 
      epidural space in 13 patients (24.5%) with 4 mL. Pain improved in all patients. 
      There was no significant difference in pain relief according to the spreading 
      pattern. CONCLUSION: The spreading pattern of injected solution in US-CRB could 
      be partially affected by the injectant volume. However, further studies are 
      needed to assess the importance of other factors, such as needle position and 
      physiological effects.
CI  - (c) 2016 American Academy of Pain Medicine. All rights reserved. For permissions, 
      please e-mail: journals.permissions@oup.com.
FAU - Kang, Seok
AU  - Kang S
AD  - Department of Physical Medicine and Rehabilitation, Korea University Guro 
      Hospital, Seoul, Korea.
FAU - Yang, Seung Nam
AU  - Yang SN
AD  - Department of Physical Medicine and Rehabilitation, Korea University Guro 
      Hospital, Seoul, Korea.
FAU - Kim, Se Hwa
AU  - Kim SH
AD  - Department of Physical Medicine and Rehabilitation, Korea University Guro 
      Hospital, Seoul, Korea.
FAU - Byun, Chan Woo
AU  - Byun CW
AD  - Department of Physical Medicine and Rehabilitation, Korea University Guro 
      Hospital, Seoul, Korea.
FAU - Yoon, Joon Shik
AU  - Yoon JS
AD  - Department of Physical Medicine and Rehabilitation, Korea University Guro 
      Hospital, Seoul, Korea rehab46@korea.ac.kr.
LA  - eng
PT  - Journal Article
DEP - 20160323
PL  - England
TA  - Pain Med
JT  - Pain medicine (Malden, Mass.)
JID - 100894201
RN  - 0 (Contrast Media)
SB  - IM
MH  - Aged
MH  - Contrast Media/*administration & dosage
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Nerve Block/*methods
MH  - Prospective Studies
MH  - Radiculopathy/*diagnostic imaging/drug therapy
MH  - Spinal Nerve Roots/*diagnostic imaging/drug effects
MH  - Ultrasonography, Interventional/*methods
OTO - NOTNLM
OT  - Cervical
OT  - Radiculopathy
OT  - Selective Nerve Root Injection
OT  - Spreading Pattern
OT  - Ultrasound
EDAT- 2016/03/25 06:00
MHDA- 2017/09/22 06:00
CRDT- 2016/03/25 06:00
PHST- 2016/03/25 06:00 [pubmed]
PHST- 2017/09/22 06:00 [medline]
PHST- 2016/03/25 06:00 [entrez]
AID - pnw027 [pii]
AID - 10.1093/pm/pnw027 [doi]
PST - ppublish
SO  - Pain Med. 2016 Nov;17(11):1978-1984. doi: 10.1093/pm/pnw027. Epub 2016 Mar 23.