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CT-guided cervical nerve root injections: comparing the immediate post-injection anesthetic-related effects of the transforaminal injection with a new indirect technique

Sutter, Reto ; Pfirrmann, Christian ; Zanetti, Marco ; Hodler, Juerg ; Peterson, Cynthia

In: Skeletal Radiology, 2011, vol. 40, no. 12, p. 1603-1608

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    Titre
    • CT-guided cervical nerve root injections: comparing the immediate post-injection anesthetic-related effects of the transforaminal injection with a new indirect technique
    Auteur
    • Sutter, Reto. Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zürich, Switzerland
    • Pfirrmann, Christian. Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zürich, Switzerland
    • Zanetti, Marco. Department of Radiology, Hirslanden Hospital, Seefeldstrasse 214, 8008, Zürich, Switzerland
    • Hodler, Juerg. Department of Radiology, University Hospital, Rämistrasse 100, 8091, Zürich, Switzerland
    • Peterson, Cynthia. Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zürich, Switzerland
    Type de document
    • Postprint
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:315742
    Summary
    Objective: To describe an "indirect” cervical nerve root injection technique with a dorsal approach that should carry less inherent risk than the "direct” cervical transforaminal injection approach, and to compare the immediate post-injection results of the two procedures. Materials and methods: The indirect and direct cervical nerve root injection procedures are described in detail. Fifty-three consecutive patients receiving the indirect nerve root injections during 2009-2010 were age- and gender-matched to 53 patients who underwent direct transforaminal nerve root injections performed in 2006. Pain level data were collected immediately before and 20-30min after each procedure. The percentages of pain change in the two groups were compared using the unpaired Student'st test. Results: Fifty-two men (mean age 49) and 54 women (mean age 55) were included. The mean percentage of pain reduction for patients receiving indirect nerve root injections was 38.4% and for those undergoing the direct nerve root injections approach it was 43.2%. This was not significantly different (P = 0.455). No immediate or late adverse effects were reported after either injection procedure. Conclusions: The indirect cervical nerve root injection procedure is a potentially safer alternative to direct cervical transforaminal nerve root injections. The short-term pain reduction is similar using the two injection methods