SPINE INTERVENTION SOCIETY – 2017 25TH ANNUAL MEETING RESEARCH ABSTRACTS
2017; Oxford University Press; Volume: 18; Issue: 8 Linguagem: Inglês
10.1093/pm/pnx183
ISSN1526-4637
AutoresAhmadolla Abdelrahimsai, Sanatorium Ra, Amit Bhargava, Samantha Benjamin, Brittany Bickelhaupt, Maxim Eckmann, Jacob Fehl, Jonathan A. Benfield, Jonathan Curley, Omid B. Rahimi, Ameet Nagpal, Jan Duncan, Zachary L. McCormick, Ariana M. Nelson, Mark C. Kendall, Robert J. McCarthy, Geeta Nagpal, David R. Walega, Charles A. Odonkor, Patricia Zheng, Byron J. Schneider, Lisa Huynh, Joshua Levin, Pranathip Rinkaekan, Ramin Kordi, Agnes Ith, David J. Kennedy,
ResumoCervical radiculopathy is a common and severe pain symptom caused by disc herniation and neuroforamenstenosis. Cervical radiculopathy annual incidence has been reported at 83/100,000 population.Patients failing to improve after physical therapy, physiotherapy, pain medication, exercise and education lack further treatment possibilities, if we want to avoid surgery or confirm indication and location of considered surgery.Fluoroscopy does not show the soft-tissue structures.CT guidance permits clear visualization of the needle but also depicts the surrounding soft tissues and vascular structures well in comparison with fluoroscopic images obtained during cervical SNRB.Intermittent fluoroscopic CT guidance significantly lowers patient and operator radiation doses compared with continuous fluoroscopic CT and general CT-guided lumbar nerve root block procedures.Therefore we regard it as best guidance for SCNRB.Methods: Our Pilot Study observed safety, pain, pain medication and NDI-score (Neck Disability) following SCNRB under fluoroscopic CT, cervical spine physiotherapy starting 2 days later.30 patients radicular pain >3months, disc herniation and VAS >5/10 NDI >40.Follow up: 1, 7, 21, 90, 180 days after SCNRB.Results: 2 patients needed disc surgery.3 patients short time relief, 25 patients good to excellent outcome regarding pain and NDI.NDI Score 48 to 10 after 3 months, VAS10 from 7 to 2.5.Complications: One unilateral Horner-Syndrome.Conclusions: Fluoroscopic-CT controlled SCNRB is the safest procedure and plus standard physiotherapy of the neck should lead to faster improvement and avoid surgery more often than each method alone.Further investigations with more patients in randomized controlled studies should follow.Reference: 1)
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