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Published on: January 31, 2025
Ultrasound-guided cervical selective nerve root block: a fluoroscopy-controlled feasibility study
Samer N Narouze1, Amaresh Vydyanathan, Leonardo Kapural
1Pain Management Department, Cleveland Clinic Foundation, 9500 Euclid Ave C25, Cleveland, OH 44195, USA. narouzs@ccf.org
Regional Anesthesia and Pain Medicine
|July 4, 2009
Summary
Ultrasound guidance for cervical nerve root injections is feasible, potentially enhancing safety by visualizing critical vessels. This imaging technique may help prevent vascular injury, a leading cause of complications.
Area of Science:
- Interventional Radiology
- Neurology
- Medical Imaging
Background:
- Cervical transforaminal injections carry risks of intravascular injection, even with fluoroscopy.
- Ultrasound offers soft tissue, nerve, and vessel visualization, potentially improving procedural safety and precision.
Purpose of the Study:
- To evaluate the feasibility of ultrasound as the primary imaging tool for cervical nerve root injections.
- To assess ultrasound's ability to identify critical vessels near the injection target.
Main Methods:
- Prospective case series of 10 patients undergoing cervical nerve root injections.
- Ultrasound was the primary imaging modality, with fluoroscopic confirmation.
- Targeting involved precise needle placement relative to the intervertebral foramen and articular pillars.
Main Results:
- High accuracy of needle placement was achieved with ultrasound guidance.
- Ultrasound identified critical vessels in unexpected locations, some potentially in the needle's path.
- Vessel visualization may aid in preventing inadvertent vascular injury.
Conclusions:
- Ultrasound guidance is feasible for selective cervical nerve root injections.
- This technique can help identify and avoid injury to critical vessels, addressing a key safety concern.
- Further randomized trials are recommended to compare ultrasound with other imaging modalities.
