Vascular Evaluation around the Cervical Nerve Roots during Ultrasound-Guided Cervical Nerve Root Block

Abstract

Introduction: To carry out ultrasound-guided cervical nerve root block (CNRB) safely, we investigated the frequency of risky blood vessels around the target nerve root and within the imaginary needle pathway in the actual injecting position. Methods: 30 patients (20 men, 10 women) with cervical radiculopathy who received ultrasound-guided CNRB were included in this study. We defined a risky blood vessel as an artery existing within 4 mm from the center of the target nerve root or located in the range of 2 mm above or below the imaginary needle pathway. Results: Using the color Doppler method, the frequency of a risky blood vessel existing around 4 mm from the center of the C5 nerve root was 3.3% (1/30), whereas it was 3.3% (1/30) for the C6 nerve root and 23.3% (7/30) for the C7 nerve root. Hence, the C7 level had more blood vessels close to the target nerve root compared to the C5 and C6 levels, but there was no significant difference (p = 0.0523). On the other hand, the frequency of a risky blood vessel existing within 2 mm above and below the imaginary needle pathway was 3.3% (1/30) for the C5 nerve root, whereas it was 3.3% (1/30) for the C6 nerve root and 10.0% (3/30) for the C7 nerve root. The C7 level had more blood vessels within the needle pathway compared to the C5 and C6 levels, but there was no significant difference (p = 0.301). Conclusions: To reduce the risk of unintended intravascular injections, more careful checking for the presence or absence of blood vessels at the C7 level using color Doppler is necessary.

Sacroiliac Joint Pain Should Be Suspected in Early Buttock and Groin Pain after Adult Spinal Deformity Surgery: An Observational Study

“…This study revealed that SIJP occurs much earlier than previously reported in cases of spinal deformity surgery using S2AI screws. Furthermore, it is clinically significant that SIJP, which occurs when perioperative physical therapy is important, is relieved by ultrasound-guided SIJ block, which can be performed quickly at the bedside, and patients are not exposed to radiation 20 . To date, the reason underlying this condition has not been determined, possibly because of its misdiagnosis as a type of wound pain or donor site pain that cannot be relieved 18 .…”

“…The average follow-up period was 16.5 ± 3.5 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) months. The average age of the 94 patients was 72.1 (±4.9) years, and the majority (89/94) were females.…”

“…Ultrasound can be performed quickly by the bedside, and patients are not exposed to radiation 20 . This allows physicians to safely and accurately perform various medical procedures.…”

A Novel Technique Using Ultrasonography in Upper Airway Management After Anterior Cervical Decompression and Fusion

“…Ultrasound can be quickly performed at the bedside, and patients are not exposed to radiation. It allows physicians to safely and accurately carry out various medical procedures [10,11] and to rapidly assess the target anatomy in operating theaters, intensive care units, emergency departments, and even in remote environments.…”

Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block

“…However, such a procedure bears the risk of accidental intravascular injection and can cause fatal complications, such as brain stem and spinal cord infarctions [ 3 ]. In contrast, ultrasound (US)-guided cervical selective nerve root block (SNRB) is a safer alternative procedure because it can be performed while identifying dangerous structures, including blood vessels and peripheral nerves around the target nerve root [ 4 , 5 , 6 , 7 , 8 ].…”