Abstract
Objective
Our aim is to assess the use of the cervical nerve root block (CNRB) in the treatment of radicular pain associated with degenerative cervical spine disease and its potential to limit the need for surgical intervention.
Methods
A retrospective review of consecutive CNRB procedures carried out between January 2008 and June 2010. All procedures were performed using a combination of local anaesthetic and steroid under fluoroscopic guidance. The inclusion criteria were brachialgia with MRI proven nerve compression and inadequate response to physiotherapy. Patients that underwent both a CNRB and facet joint injections were excluded. The outcome measures assessed were the response gained (complete/temporary/no relief) and the choice of further management.
Results
A total of 121 patients underwent CNRBs within our study period. 11 patients were lost to follow up. A cohort of 110 patients was studied (49 male and 61 female) with a mean age of 51.5 years (standard deviation 12.3 years).
Following the initial CNRB, 49 patients (44.5%) had complete relief requiring no further interventions. Temporary symptom relief was achieved for 30 patients (27.3%) and no relief was gained in 31 patients (31.2%). A repeat CNRB was carried out in 19 patients who gained temporary or no benefit following the initial block.
Of the 97 patients who have a complete follow up, complete resolution of symptoms was achieved in 53 patients (54.6%), 25 patients (25.8%) progressed to requiring surgery and no further treatment was offered to 19 patients (19.6%). No complications related to the procedure were identified.
Conclusion
Cervical nerve root blocks can be performed to treat patients suffering with cervical radiculopathy symptoms. It is a minimally invasive intervention that can reduce the need for operative intervention.
