Twenty-One-Year Experience With Cervical Diagnostic Blocks and Denervation: A Study of 1031 Cases at a Single...

Cervical neck pain is a significant public health issue due to its prevalence and profound impact on the quality of life of patients. The demand for treatments has surged in recent years.

The primary aim of this study is to study our practice over the past two decades (2001-2021) regarding expert recommendations. Our secondary aims are documenting any complications encountered and attempting to identify predictors of positive outcomes following cervical medial branch block (CMBB) treatment.

This single-centre retrospective study involved 729 patients who underwent CMBB or cervical medial branch denervation (CMBD) from 2001 to 2021. A total of 1031 procedures (729 CMBB and 302 CMBD) were performed, predominantly using a posterior approach (98.93%) and fluoroscopic guidance with a sentinel neurostimulator (98.84%). Corticosteroids were administered in 69.96% of CMBBs. Computed tomography (CT) scans and nuclear magnetic resonance imaging (NMR) were the most common preliminary investigations, performed in 60.72% and 53.93% of cases, respectively, with a minor complication rate of 0.49%. There were significant positive associations between successful CMBB outcomes and prior CT scans availability, physical medicine interventions, and a history of cervical trauma. Conversely, a prior NMR was associated with negative responses to CMBB.

Our findings suggest that prior CT scans availability, prior management with physical medicine, and a history of cervical trauma are associated with favorable CMBB outcomes, whereas prior NMR correlates with poorer responses. There is potential for improvement in our use of corticosteroids in CMBB procedures. The complication rate in our study was under 0.5%, with all complications being minor. Further prospective studies are warranted to corroborate these findings.