초음파를 이용한 하부 경추에서의 선택적 신경근 차단술
The Ultrasound-guided Selective Nerve Root Injections in the Lower Cervical Spines
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Objective: To introduce the technique of the ultrasound- guided selective nerve root injection in the lower cervical spine and to evaluate its accuracy and distribution patterns of injections. Method: Thirty-one patients with the cervical radiculopathies (C5 to C7) from cervical disc herniation were enrolled in this study. Targeted nerve root image was obtained and the needle was introduced to its dorsal surface under the ultrasound guidance. Then 2 ml of contrast media was injected which was followed by fluoroscopic image. The accurate injection was defined as the contrast media placed over the neural foramen along the targeted nerve root. Results: 24 of 31 (77.4%) procedures were assesed to be accurately placed and there was no significant complication. The accuracy of injection was lower at the C7 nerve root (70.0%) than other nerve roots. In all cases, large amount of back flow to the brachial plexus and spread to the adjacent nerve roots were observed.Conclusion: In the lower cervical spines, ultrasound-guided selective nerve root injections might be considered as a radiation free, safe and available method.
Abstract
Objective: To introduce the technique of the ultrasound- guided selective nerve root injection in the lower cervical spine and to evaluate its accuracy and distribution patterns of injections. Method: Thirty-one patients with the cervical radiculopathies (C5 to C7) from cervical disc herniation were enrolled in this study. Targeted nerve root image was obtained and the needle was introduced to its dorsal surface under the ultrasound guidance. Then 2 ml of contrast media was injected which was followed by fluoroscopic image. The accurate injection was defined as the contrast media placed over the neural foramen along the targeted nerve root. Results: 24 of 31 (77.4%) procedures were assesed to be accurately placed and there was no significant complication. The accuracy of injection was lower at the C7 nerve root (70.0%) than other nerve roots. In all cases, large amount of back flow to the brachial plexus and spread to the adjacent nerve roots were observed.Conclusion: In the lower cervical spines, ultrasound-guided selective nerve root injections might be considered as a radiation free, safe and available method.
참고문헌 (15)
- Galiano K, "Ultrasound-guided periradicular injections in the middle to lower cervical spine: an imaging study of a new approach", Reg Anesth Pain Med, 30, pp.391~396 (2005)
- Narouze SN, "Ultrasound-guided cervical periradicular injection: cautious optimism", Reg Anesth Pain Med, 31, pp.87~88 (2006)
- Saal JS, "Nonoperative management of herniated cervical intervertebral disc with radiculopathy", Spine, 21, pp.1877~1883 (1996)
- Cyteval C, "Cervical radiculopathy: open study on percutaneous periradicular foraminal steroid infiltration performed under CT control in 30 patients", Am J Neuroradiol, 25, pp.441~445 (2004)
- Vallee JN, "Chronic cervical radiculopathy: lateral-approach periradicular corticosteroid injection", Radiology, 218, pp.886~892 (2001)
- Kolstad F, "Transforaminal steroid injections in the treatment of cervical radiculopathy. A prospective outcome study", Acta Neurochir, 147, pp.1065~1070 (2005)
- Anderberg L, "Transforaminal steroid injections for the treatment of cervical radiculopathy: a prospective and randomised study", Eur Spine J, 16, pp.321~328 (2007)
- Van Zundert J, "The role of the dorsal root ganglion in cervical radicular pain: diagnosis, pathophysiology, and rationale for treatment", Reg Anesth Pain Med, 31, pp.152~167 (2006)
- Bose B, "Quadriparesis following cervical epidural steroid injections: case report and review of the literature", Spine J, 5, pp.558~563 (2005)
- Scanlon GC, "Cervical transforaminal epidural steroid injections: more dangerous than we think?", Spine, 32, pp.1249~1256 (2007)
- Hoeft MA, "Cervical transforaminal injection and the radicular artery: variation in anatomical location within the cervical intervertebral foramina", Reg Anesth Pain Med, 31, pp.270~274 (2006)
- Furman MB, "Incidence of intravascular penetration in transforaminal cervical epidural steroid injections", Spine, 28, pp.21~25 (2003)
- Tiso RL, "Adverse central nervous system sequelae after selective transforaminal block: the role of corticosteroids", Spine J, 4, pp.468~474 (2004)
- Dreyfuss P, "Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain", Pain Med, 7, pp.237~242 (2006)
- Anderberg L, "Distribution patterns of transforaminal injections in the cervical spine evaluated by multi-slice computed tomography", Eur Spine J, 15, pp.1465~1471 (2006)