Cervical Radicular Pain

Zundert, Jan Van; Huntoon, Marc A.; Patijn, Jacob; Lataster, Arno; Mekhail, Nagy; Kleef, Maarten van

doi:10.1002/9781119968375.ch4

Cited by 4 publications

(7 citation statements)

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“…[104][105][106][107] The exact mechanism(s) behind these complications are not yet fully understood, but in broad lines, we can distinguish between direct lesions of the spinal cord caused by anterior spinal artery syndrome and effects on the central nervous system involving brain stem and cerebellum related to inadvertent injection into the vertebral artery. 1 For the cases of transient blindness, reversible posterior leukoencephalopathy syndrome, perhaps secondary to vasospasm or embolization of vascular structures, has been implicated. In a 2003 case report, the procedure was aborted after initial aspiration, then nonionic contrast injection revealed possible vertebral artery puncture, suggesting a mechanism other than particulate steroid embolization.…”

Section: Transforaminal Epidural Corticosteroid Administrationmentioning

confidence: 99%

“…The vertebral artery can be subdivided into three segments: V1, V2, and V3. 1 The V1 segment represents the distance from the origin of the vertebral artery at the subclavian artery to its entry in the cervical transverse foramen at the C6 or C7 vertebral level. The V2 segment represents the area from entrance in the transverse foramen to its exit out of the C2-3 transverse foramen.…”

Section: Anatomical Considerationsmentioning

confidence: 99%

“…This narrative review is based on the article "cervical radicular pain" published in 2009. 1 In 2015, an independent company, Kleijnen Systematic Reviews (KSR), performed a systematic review of the literature for the period 2009-2015, based on existing systematic reviews (SRs) and randomized controlled trials (RCTs). 16 For the current article, an updated search was conducted for the period 2015-2022, using "cervical" and "radicular" and "pain" associated with the interventional pain management techniques, in this case "epidural" and "steroid" or "corticosteroid"; "radiofrequency" or "pulsed radiofrequency"; "spinal cord stimulation."…”

Section: Et Hodologymentioning

confidence: 99%

“…Needle electromyography (EMG) and nerve-conduction tests (NCT) can be useful when patient history and physical examination do not allow differentiation between cervical radicular pain and other neurologic causes of neck and arm pain. 1 Typically, abnormal insertional activity, including positive sharp-wave potentials and fibrillation potentials, is present in the limb muscles of the involved myotome within 3 weeks of the onset of nerve compression. 40 Large-scale studies evaluating the sensitivity and specificity of electrophysiological tests are lacking, with one prospective study performed in 101 patients reporting sensitivities > 90% with at least five muscle screens including the paraspinals.…”

Section: Electrophysiological Testsmentioning

confidence: 99%

“…In these patients, pulsed radiofrequency (PRF) treatment adjacent to the dorsal root ganglion (DRG) may be considered. 1,59 Epidural corticosteroid administration…”

Section: Interventional Pain Managementmentioning

confidence: 99%

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2. Cervical radicular pain

et al. 2023

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IntroductionCervical radicular pain is pain perceived in the upper limb, caused by irritation or compression of a cervical spine nerve, the roots of the nerve, or both.MethodsThe literature on the diagnosis and treatment of cervical radicular pain was retrieved and summarized.ResultsThe diagnosis is made by combining elements from the patient's history, physical examination, and supplementary tests. The Spurling and shoulder abduction tests are the two most common examinations used to identify cervical radicular pain. MRI without contrast, CT scanning, and in some cases plain radiography can all be appropriate imaging techniques for nontraumatic cervical radiculopathy. MRI is recommended prior to interventional treatments. Exercise with or without other treatments can be beneficial. There is scant evidence for the use of paracetamol, nonsteroidal anti‐inflammatory drugs, and neuropathic pain medications such as gabapentin, pregabalin, tricyclic antidepressants, and anticonvulsants for the treatment of radicular pain. Acute and subacute cervical radicular pain may respond well to epidural corticosteroid administration, preferentially using an interlaminar approach. By contrast, for chronic cervical radicular pain, the efficacy of epidural corticosteroid administration is limited. In these patients, pulsed radiofrequency treatment adjacent to the dorsal root ganglion may be considered.ConclusionsThere is currently no gold standard for the diagnosis of cervical radicular pain. There is scant evidence for the use of medication. Epidural corticosteroid injection and pulsed radiofrequency adjacent to the dorsal root ganglion may be considered. [Correction added on 12 June 2023, after first online publication: The preceding sentence was corrected.]

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Section: Transforaminal Epidural Corticosteroid Administrationmentioning

confidence: 99%

Section: Anatomical Considerationsmentioning

confidence: 99%

Section: Et Hodologymentioning

confidence: 99%

Section: Electrophysiological Testsmentioning

confidence: 99%

“…In these patients, pulsed radiofrequency (PRF) treatment adjacent to the dorsal root ganglion (DRG) may be considered. 1,59 Epidural corticosteroid administration…”

Section: Interventional Pain Managementmentioning

confidence: 99%

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2. Cervical radicular pain

et al. 2023

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1. Lumbosacral radicular pain

Peene,

Cohen,

Kallewaard

et al. 2023

Pain Practice

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IntroductionPatients suffering lumbosacral radicular pain report radiating pain in one or more lumbar or sacral dermatomes. In the general population, low back pain with leg pain extending below the knee has an annual prevalence that varies from 9.9% to 25%.MethodsThe literature on the diagnosis and treatment of lumbosacral radicular pain was reviewed and summarized.ResultsAlthough a patient's history, the pain distribution pattern, and clinical examination may yield a presumptive diagnosis of lumbosacral radicular pain, additional clinical tests may be required. Medical imaging studies can demonstrate or exclude specific underlying pathologies and identify nerve root irritation, while selective diagnostic nerve root blocks can be used to confirm the affected level(s).In subacute lumbosacral radicular pain, transforaminal corticosteroid administration provides short‐term pain relief and improves mobility. In chronic lumbosacral radicular pain, pulsed radiofrequency (PRF) treatment adjacent to the spinal ganglion (DRG) can provide pain relief for a longer period in well‐selected patients. In cases of refractory pain, epidural adhesiolysis and spinal cord stimulation can be considered in experienced centers.ConclusionsThe diagnosis of lumbosacral radicular pain is based on a combination of history, clinical examination, and additional investigations. Epidural steroids can be considered for subacute lumbosacral radicular pain. In chronic lumbosacral radicular pain, PRF adjacent to the DRG is recommended. SCS and epidural adhesiolysis can be considered for cases of refractory pain in specialized centers.

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Interventional pain treatment modalities in palliation of rheumatic pains

Köken

Eyigör

2019

Ege Tıp Dergisi

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Romatolojik hastalıkların klinik seyrinde sıklıkla kas-iskelet sistemine lokalize romatizmal ağrılar ortaya çıkmaktadır. Yeterli ve etkin ağrı palyasyonu yapılmayan romatizmal ağrılar kronikleşerek hastalarda fonksiyonel yetersizlik ve yaşam kalitesinde azalmaya yol açmaktadır. Romatizmal ağrıların tedavisi altta yatan romatolojik hastalığın nedenine göre değişmekle birlikte başlıca fizik tedavi, farmakoterapi, girişimsel ağrı tedavileri ve cerrahi seçenekleri kapsamaktadır. Romatizmal ağrılarda girişimsel ağrı tedavileri, farmakoterapi ve fizik tedavi gibi non-invaziv olan diğer tedavi seçeneklerinin yetersiz kaldığı durumlarda kullanılmaktadır. Bu makalede romatizmal ağrıların girişimsel ağrı tedavisi üzerinde durulacaktır.

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Cervical Radicular Pain

Cited by 4 publications

References 59 publications

2. Cervical radicular pain

2. Cervical radicular pain

1. Lumbosacral radicular pain

Interventional pain treatment modalities in palliation of rheumatic pains

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