An open-label non-inferiority randomized trail comparing the effectiveness and safety of ultrasound-guided selective cervical nerve root block and fluoroscopy-guided cervical transforaminal epidural block for cervical radiculopathy

Cui, Xiaohong; Zhang, Di; Zhao, Yongming; Song, Yonghui; He, Lin; Zhang, Jian

doi:10.1080/07853890.2022.2124445

Cited by 7 publications

(8 citation statements)

References 35 publications

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“…Various studies have shown that there is no significant difference in the success rate, pain relief, and functional improvement between ultrasound-guided SNRB versus fluoroscopy-guided transforaminal injection when treating CSR. However, ultrasound-guided SNRB has the advantage of no radiation, no serious complications, and being more efficient [ 8 , 24 , 28 ]. Some blood vessels are also present around some cervical nerve roots, with the Doppler mode of ultrasound being able to detect any located around the target.…”

Section: Discussionmentioning

confidence: 99%

“…Some blood vessels are also present around some cervical nerve roots, with the Doppler mode of ultrasound being able to detect any located around the target. This procedure effectively avoids intravascular injection, and enhances the safety of the entire treatment process [ 24 , 28 , 29 ]. In our study, three subjects in the two groups interrupted treatment after vasovagal reaction occurred (adverse reaction rate: 1.87%).…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided injection acupotomy as a minimally invasive intervention therapy for cervical spondylotic radiculopathy: a randomized control trial

Cao

Chen

et al. 2023

Annals of Medicine

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Objective To explore the efficacy and safety of ultrasound-guided injection acupotomy as a minimally invasive intervention treatment of cervical spondylotic radiculopathy (CSR). Methods 160 CSR subjects were recruited who met the inclusion criteria in our hospital from October 2019 to December 2021. The subjects were randomly divided into the experimental and control group, with 80 cases in each. The experimental group received ultrasound-guided injection acupotomy as a minimally invasive intervention therapy. The control group received ultrasound-guided selective nerve root block (SNRB). The Odom’s criteria clinical curative effect, visual analogue scale (VAS), neck disability index (NDI), and 36-Item Short Form Health Survey questionnaire (SF-36) were used to evaluate the outcome of subjects at several different points in time. Results At 30 min and 1 month after the end of treatment, there was no significant difference in any scores. However, after six months, the excellent and good rate was better in the experimental group compared to the control (RD = 0.175; 95% CI, 0.044–0.300, p = 0.009). The total effective rate was also better in the experimental group (RD = 0.126; 95% CI, 0.021–0.232, p = 0.018). In contrast, the VAS score (MD = −0.500; 95% CI, −1.000–0.000, p = 0.030) and NDI score (MD = −6.460; 95% CI, −11.067 to −1.852, p = 0.006) were lower in the experimental group compared to the control. The total SF-36 score was higher in the experimental group (MD = 7.568; 95% CI, 2.459–12.677, p = 0.004). Conclusion Ultrasound-guided injection acupotomy minimally invasive interventional treatment of CSR has no significant difference in short-term curative effect compared with ultrasound-guided SNRB, but the data indicators are significantly better than the latter at 6 months after the end of the course of treatment, showing better long-term efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided injection acupotomy as a minimally invasive intervention therapy for cervical spondylotic radiculopathy: a randomized control trial

Cao

Chen

et al. 2023

Annals of Medicine

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“…Ultrasound guidance produces similar clinical response to fluoroscopy-guided interventions but is able to identify arteries in association with the foramen which are subject to inadvertent intravascular injection. 19,20…”

Section: Cervical Radiculopathymentioning

confidence: 99%

“…While ultrasound is not routinely used in the diagnosis of cervical radiculopathy, there is a body of literature demonstrating the utility of ultrasound to guide peri‐radicular injections. Ultrasound guidance produces similar clinical response to fluoroscopy‐guided interventions but is able to identify arteries in association with the foramen which are subject to inadvertent intravascular injection 19,20 …”

Section: Radiculopathymentioning

confidence: 99%

Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

Hannaford,

Paling,

Silsby

et al. 2024

Muscle and Nerve

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Electrodiagnostic studies (EDx) are frequently performed in the diagnostic evaluation of peripheral nerve disorders. There is increasing interest in the use of newer, alternative diagnostic modalities, in particular imaging, either to complement or replace established EDx protocols. However, the evidence to support this approach has not been expansively reviewed. In this paper, diagnostic performance data from studies of EDx and other diagnostic modalities in common peripheral nerve disorders have been analyzed and described, with a focus on radiculopathy, plexopathy, compressive neuropathies, and the important neuropathy subtypes of Guillain‐Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), vasculitic neuropathy and diabetic neuropathy. Overall EDx retains its place as a primary diagnostic modality in the evaluated peripheral nerve disorders. Magnetic resonance imaging and ultrasound have developed important complementary diagnostic roles in compressive and traumatic neuropathies and atypical CIDP, but their value is more limited in other neuropathy subtypes. Identification of hourglass constriction in nerves of patients with neuralgic amyotrophy may have therapeutic implications. Investigation of radiculopathy is confounded by poor correlation between clinical features and imaging findings and the lack of a diagnostic gold standard. There is a need to enhance the literature on the utility of these newer diagnostic modalities.

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“…Facet joint injections are one of the most common procedures performed by pain management anesthesiologists [5]. Injections can be directed by fluoroscopy, computed tomography (CT), and palpation or loss-of-resistance techniques [6]. Techniques such as fluoroscopy and CT have significant disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Deep Learning Detection and Segmentation of Facet Joints in Ultrasound Images Based on Convolutional Neural Networks and Enhanced Data Annotation

Wu,

Xia,

Wang

et al. 2024

Diagnostics

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The facet joint injection is the most common procedure used to release lower back pain. In this paper, we proposed a deep learning method for detecting and segmenting facet joints in ultrasound images based on convolutional neural networks (CNNs) and enhanced data annotation. In the enhanced data annotation, a facet joint was considered as the first target and the ventral complex as the second target to improve the capability of CNNs in recognizing the facet joint. A total of 300 cases of patients undergoing pain treatment were included. The ultrasound images were captured and labeled by two professional anesthesiologists, and then augmented to train a deep learning model based on the Mask Region-based CNN (Mask R-CNN). The performance of the deep learning model was evaluated using the average precision (AP) on the testing sets. The data augmentation and data annotation methods were found to improve the AP. The AP50 for facet joint detection and segmentation was 90.4% and 85.0%, respectively, demonstrating the satisfying performance of the deep learning model. We presented a deep learning method for facet joint detection and segmentation in ultrasound images based on enhanced data annotation and the Mask R-CNN. The feasibility and potential of deep learning techniques in facet joint ultrasound image analysis have been demonstrated.

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An open-label non-inferiority randomized trail comparing the effectiveness and safety of ultrasound-guided selective cervical nerve root block and fluoroscopy-guided cervical transforaminal epidural block for cervical radiculopathy

Cited by 7 publications

References 35 publications

Ultrasound-guided injection acupotomy as a minimally invasive intervention therapy for cervical spondylotic radiculopathy: a randomized control trial

Ultrasound-guided injection acupotomy as a minimally invasive intervention therapy for cervical spondylotic radiculopathy: a randomized control trial

Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

Deep Learning Detection and Segmentation of Facet Joints in Ultrasound Images Based on Convolutional Neural Networks and Enhanced Data Annotation

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