Ultrasound-guided cervical selective nerve root block with or without steroid

Area of Science:

• Pain Medicine
• Interventional Radiology
• Neurology

Background:

• Cervical radicular pain significantly impacts quality of life.
• Ultrasound-guided selective nerve root blocks (SNRB) are utilized for cervical radicular pain.
• The role of steroids in SNRB for pain management requires further elucidation.

Purpose of the Study:

• To compare short-term pain trajectories after ultrasound (US)-guided cervical selective nerve root block (SNRB).
• To evaluate the efficacy of a steroid-containing injectate versus a no-steroid injectate.
• To assess pain reduction in patients with cervical radicular pain.

Main Methods:

• Prospective comparative study of 70 patients undergoing first-time US-guided cervical SNRB.
• Patients received either a steroid (betamethasone) or no-steroid injectate.
• Pain intensity assessed via Numerical Rating Scale (NRS) at multiple time points up to 14 days.

Main Results:

• Significant group-by-time interaction observed (p=0.0036).
• The steroid group showed significantly greater pain improvement at day 14 (difference of -1.55 NRS points, p=0.0077).
• Pain relief favored the steroid group from 15 minutes through day 14 with no observed complications.

Conclusions:

• Ultrasound-guided cervical SNRB with betamethasone is associated with superior short-term pain improvement.
• The addition of betamethasone to SNRB for cervical radicular pain is safe and effective.
• Steroid-containing injectates enhance pain relief in US-guided cervical SNRB.