Spinal Cord Injury During Ultrasound-Guided C7 Cervical Medial Branch Block

Park, Donghwi; Seong, Min Yong; Kim, Ha Yong; Ryu, Ju Seok

doi:10.1097/phm.0000000000000613

Cited by 20 publications

(12 citation statements)

References 9 publications

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“…However, the prevalence of cervical disc disorders was consistent with previous studies. [ 21 – 26 ] In other words, this study is of relevance as it suggests that the findings of the patients studied here should be able to be applied appropriately to other analogous populations with cervical disc disorders. Further studies that incorporate a higher number of participants and longitudinal periods will be needed to clarify this shortcomings.…”

Section: Discussionmentioning

confidence: 84%

Predictability of severity of disc degeneration and disc protrusion using horizontal displacement of cervical dynamic radiographs

et al. 2018

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The aim of this study is to investigate the usefulness of flexion-extension (dynamic) radiographs in evaluating the severity of disc degeneration and disc protrusion in cervical magnetic resonance image (MRI). Patients complaining of neck or arm pain with no prior surgical history and who had undergone both cervical MRI and dynamic radiographs were included in this study. The following patients were excluded: those who had any history of trauma, autoimmune disease such as rheumatoid arthritis or ankylosing spondylitis, prior cervical fracture or prior cervical spine surgery. Based on these criteria, 161 patients who visited our department for neck pain or upper extremity radicular symptoms were initially included retrospectively. Among them, 69 patients were excluded due to the lack of cervical MRI or dynamic radiographs. Therefore, a total of 92 patients were included for analysis in this study. The maximal diameter of disc protrusion in sagittal or axial MRI, the severity of cervical disc degeneration, and segmental horizontal displacement in dynamic cervical radiographs are the main outcome measurements. In the results of this study, the extension radiograph of C5/6 had the highest sensitivity (93.33%) and specificity (100%) in predicting cervical disc protrusion followed by C4/5 (sensitivity; 77.28%, specificity 92.86%) among the dynamic radiographs. Segmental horizontal displacement at the C3/4, C4/5, and C5/6 level in the neutral and extension radiographs had a significant correlation with the severity of cervical disc degeneration in MRI (P < .05). At the C6/7 level, however, only extension radiograph had a significant correlation with the severity of cervical disc degeneration in the MRI (P < .05). In conclusion, if MRI is not available in a primary clinical setting, dynamic cervical radiographs may be useful in predicting the severity of degenerative disc and disc protrusion in cervical MRI. Among the dynamic cervical radiographs, the extension radiograph was the most sensitive for predicting the severity of cervical disc degeneration and disc protrusion, especially at the C3/4, C4/5, C5/6, and C6/7 levels in MRI.

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Section: Discussionmentioning

confidence: 84%

Predictability of severity of disc degeneration and disc protrusion using horizontal displacement of cervical dynamic radiographs

et al. 2018

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“…C7 medial branches were visualized on sonography in only one-third of cases 46 . Not surprisingly, a case of iatrogenic spinal cord injury from an US-guided C7 CMBB was reported 47 . This was the first, and, to the best of our knowledge, the only serious injury from the US-guided CMBBs.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Cervical Medial Branch Blocks: A Systematic Review and Meta-Analysis

Souza

2020

AHM Journal

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Objective: Cervical medial branch blocks (CMBBs) are useful in differentiating facetogenic pain from other sources of cervicogenic headaches and neck pain. The purpose of this systematic review and meta-analysis is to determine the efficacy, performance time, pain reduction, and adverse events associated with ultrasound (US) guided CMBB compared with other commonly used guidance methods such as fluoroscopy and computed tomography (CT). Methods: Searches of MEDLINE, EMBASE, Cochrane Library, and Ovid were completed to identify studies addressing CMBBs utilizing ultrasound compared to other imaging techniques. Three reviewers independently screened the titles, abstracts, and full texts, extracting data from eligible studies. Outcomes of interest including success rate, efficacy, performance time and complication profile were analyzed in meta-analysis. All other reported measures and complication profiles were analyzed descriptively. Results: A total of 9 studies were included. Four randomized controlled trials (RCTs) and 5 cohort studies satisfied inclusion criteria. US-guided CMBBs demonstrated similar success rates (OR = 1.05, 95% CI = 0.15 to 7.52, z = 0.05, P = 0.96) and similar pain efficacy (SMD = -0.54, 95% CI = -1.91 to 0.83, z = - 0.77, P = 0.44) compared to traditional guidance techniques. However, US-guided CMBBs demonstrated reduced performance time (SMD = -1.77, 95% CI = -2.65 to -0.89, z = -3.94, P <0.01) and rate of vascular injury/injection (OR = 0.09, 95% CI = 0.01 to 0.75, z = -2.23, P = 0.03) compared to fluoroscopy guided CMBBs. Conclusion: This review and meta-analysis demonstrated that US-guided cervical medial branch blocks are a reliable alternative to fluoroscopy- and CT-guided CMBBs, with similar efficacy but a potentially improved safety and performance time.

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“…In the initial neurological examination, the patient's motor power of both the upper and lower extremities was normal except for the left shoulder elevation and elbow flexion, which were grade 2 (Medical Research Council grade) in the manual muscle test (MMT). [ 10 ] In computed tomography (CT) of the cervical spine, a fracture of the left articular process in the C4 spine was observed, and mild swelling and increased signal in the left C5 spinal nerve root were observed on coronal T2-weighted short tau inversion recovery (STIR) images (Fig. 1 ).…”

Section: Case Reportmentioning

confidence: 99%

Application of ultrasound-guided C5 nerve root block using polydeoxyribonucleotide in traumatic C5 nerve root injury caused by fracture of the articular process of the cervical spine

Park

2017

Medicine

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Rationale:Cervical nerve root injury is one of the complications of traumatic cervical spine fracture. Although one of the most effective treatments to reduce inflammation in nerve root injuries is the use of corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids and NSAIDs can inhibit bone healing. So, when nerve injury accompanies bone fractures, corticosteroids and NSAIDs have limitations as therapeutic agents. However, polydeoxyribonucleotide (PDRN) may be useful in the treatment of neuropathy or musculoskeletal pain patients with contraindication of the use of corticosteroids because of its anti-inflammatory effect, as revealed in previous studies. To the best of our knowledge, there has been no report of treatment of traumatic nerve root injury due to an articular process fracture with an ultrasound-guided cervical nerve root block (NRB) using PDRN.Patients concerns:A 54-year-old female patient with motor weakness of the left upper extremity and tingling sensation in the left neck and shoulder.Diagnoses:traumatic C5 nerve root injury due to a fracture of the left articular process in the C4 spine.Intervention:Ultrasound-guided C5 NRB using PDRN.Outcomes:Her motor weakness and sensory symptoms of the left upper extremity were significantly improved after treatment using an ultrasound-guided C5 NRB using PDRN.Lessons:Although it is impossible to draw a conclusion from a single case report, we suggest the ultrasound-guided NRB using PDRN could be a useful treatment for alleviating motor weakness and neuropathic pain caused by traumatic spinal nerve root injury in situations where corticosteroids cannot be used.

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Spinal Cord Injury During Ultrasound-Guided C7 Cervical Medial Branch Block

Cited by 20 publications

References 9 publications

Predictability of severity of disc degeneration and disc protrusion using horizontal displacement of cervical dynamic radiographs

Predictability of severity of disc degeneration and disc protrusion using horizontal displacement of cervical dynamic radiographs

Ultrasound-Guided Cervical Medial Branch Blocks: A Systematic Review and Meta-Analysis

Application of ultrasound-guided C5 nerve root block using polydeoxyribonucleotide in traumatic C5 nerve root injury caused by fracture of the articular process of the cervical spine

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