Journal of Pain & Relief
Open Access

Abstract

Aim: Catastrophic complications have been reported for selective cervical nerve root block (SCNRB) or pulsed radiofrequency (PRF) via an anterolateral transforaminal approach. Aim of this study is to report a posterior approach to SCNRB and PRF under fluoroscopy guidance and the clinical outcomes of this combined treatment, which has not been reported. Methods: We retrospectively reviewed the clinical outcomes of 42 patients with CCRP who received a combination of SCNRB and PRF through a posterior approach under fluoroscopy guidance. The thresholds of electrical stimulation and imaging of the nerve roots after contrast injection were used to evaluate the accuracy of needle placement. The numeric rating scale (NRS) was used to measure the pain and numbness levels as primary clinical outcomes, which were obtained in scheduled follow up visits. Results: A total of 53 procedures were performed on 42 patients at the levels of C5 through C8. All patients reported concordant paraesthesia in response to electrical stimulation. The average sensory and motor thresholds of stimulation were 0.28�±0.14 and 0.36�±0.14 volts respectively. Injection of contrast resulted in excellent spread along the target nerve root in the large majority of the procedures. The NRS scores for both pain and numbness improved significantly at one day, one week, one month and three months after the treatment. No serious adverse effects were observed in any of the patients. Conclusions: The posterior approach to combined SCNRB and PRF under fluoroscopy guidance appears to be safe and efficacious in the management of cervical radicular pain.

Biography

Lizu Xiao is a Chief Pain Physician and Deputy Director for the Department of Pain Management of Shenzhen Nanshan Hospital in Guangdong, China. He is a member of International Association for the Study of Pain (IASP) and National Committee of Chinese Association for the Study of Pain (CASP) from 2013. He is an Editor of the Chinese Pain Medicine Journal, Professor and Mentor of Guangdong Medical College. He was a Visiting Scholar of the Stanford University from 2009 to 2010.

Email: nsyyjoe@live.cn