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Skeletal Radiology
Erschienen in: Skeletal Radiology 1/2017

04.11.2016 | Scientific Article

Ultrasound versus fluoroscopy-guided cervical medial branch block for the treatment of chronic cervical facet joint pain: a retrospective comparative study

verfasst von: Ki Deok Park, Dong-Ju Lim, Woo Yong Lee, JaeKi Ahn, Yongbum Park

Erschienen in: Skeletal Radiology | Ausgabe 1/2017

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Abstract

Objective

To compare the mid-term effects and advantages of the ultrasound (US)-guided with fluoroscopy(FL)-guided cervical medial branch blocks (CMBBs) for chronic cervical facet joint pain through assessment of pain relief, functional improvement, and injection efficiency.

Methods

Patients with chronic cervical facet joint pain who received US- (n = 68) or FL-guided CMBBs (n = 58) were included in this retrospective study. All procedures were performed using a FL or US. The complication frequencies, treatment effects, functional improvement, and injection efficiency of CMBBs were compared at 1, 3, and 6 months after the last injection.

Results

Both the NDI and VNS scores showed improvements at 1, 3, and 6 months after the last injection in both groups, with no significant differences between groups (p < 0.05). Furthermore, the treatment success rate at all time points was not significantly different between groups. Logistic regression analysis revealed that the injection method (US- or FL-guided), the number of injections, sex, analgesic use, and age were not independent predictors of treatment success. Compared with FL-guided CMBB, US-guided CMBB was associated with a shorter administration duration and fewer needle passes.

Conclusions

Our results suggest that, compared with FL-guided CMBBs, US-guided CMBBs require a shorter administration duration and fewer needle passes, while providing similar pain relief and functional improvements. Therefore, US-guided CMBBs can be considered as an effective alternative for the conservative management of chronic cervical facet joint pain.
Literatur
1.
Barnsley L, Lord SM, Wallis BJ, Bogduk N. The prevalence of chronic cervical zygapophyseal joint pain after whiplash. Spine. 1995;20:20–6.CrossRefPubMed
2.
Lord SM, Barnsley L, Wallis BJ, Bogduk N. Chronic cervical zygapophysial joint pain with whiplash: a placebo-controlled prevalence study. Spine. 1996;21:1737–45.CrossRefPubMed
3.
Yin W, Bogduk N. The nature of neck pain in a private pain clinic in the United States. Pain Med. 2008;9:196–203.CrossRefPubMed
4.
Manchikanti L, Boswell MV, Singh V, Pampati V, Damron KS, Beyer CD. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions. BMC Musculoskelet Disord. 2004;5:15.CrossRefPubMedPubMedCentral
5.
Manchikanti L, Staats P, Singh V, Schultz DM, Vilims BD, Jasper JF, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2003;6:3–80.PubMed
6.
Boswell MV, Shah RV, Everett CR, Sehgal N, Mckenzie-Brown AM, Abdi S, et al. Interventional techniques in the management of chronic spinal pain: evidence based practice guidelines. Pain Physician. 2005;8:1–47.PubMed
7.
Falco FJE, Erhart S, Wargo BW, Bryce DA, Atluri S, Datta S, et al. Systematic review of diagnostic utility and therapeutic effectiveness of cervical facet joint interventions. Pain Physician. 2009;12:323–44.PubMed
8.
Rubinstein SM, van Tulder M. A best-evidence review of diagnostic procedures for neck and low-back pain. Best Pract Res Clin Rheumatol. 2008;22:471–82.CrossRefPubMed
9.
Manchikanti L, Boswell MV, Singh V, Benyamin RM, Fellows B, Abdi S, et al. Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2009;12:699–802.PubMed
10.
Manchikanti L, Boswell MV, Singh V, Derby R, Fellows B, Falco FJE, et al. Comprehensive review of neurophysiologic basis and diagnostic interventions in managing chronic spinal pain. Pain Physician. 2009;12:E71–E120.PubMed
11.
Manchikanti L, Staats P, Singh V, Schultz DM, Vilims BD, Jasper JF, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2003;6:3–81.PubMed
12.
Barnsley L, Lord SM, Wallis BJ, Bogduk N. Lack of effect of intra-articular corticosteroids for chronic pain in the cervical zygapophyseal joints. N Engl J Med. 1994;330:1047–50.CrossRefPubMed
13.
Manchikanti L, Datta S, Gupta S, Munglani R, Bryce DA, Ward SP, et al. A critical review of the American Pain Society clinical practice guidelines for interventional techniques: Part 2. Therapeutic interventions. Pain Physician. 2010;13:E215–64.PubMed
14.
American Society of Anesthesiologists Task Force on Chronic Pain Management; American Society of Regional Anesthesia and Pain Medicine. Practice guidelines for chronic pain management: an updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology. 2010;112:810–33.CrossRef
15.
Manchikanti L, Singh V, Derby R, Schultz DM, Benyamin RM, Prager JP, et al. Reassessment of evidence synthesis of occupational medicine practice guidelines for interventional pain management. Pain Physician. 2008;11:393–482.PubMed
16.
Manchikanti L, Singh V, Falco FJ, Cash KA, Fellows B. Comparative outcomes of a 2-year follow-up of cervical medial branch blocks in management of chronic neck pain: a randomized, double-blind controlled trial. Pain Physician. 2010;13:437–50.PubMed
17.
Eichenberger U, Greher M, Kapral S, Marhofer P, Wiest R, Remonda L, et al. Sonographic visualization and ultrasound-guided block of the third occipital nerve: prospective for a new method to diagnose C2-C3 zygapophysial joint pain. Anesthesiology. 2006;104:303–8.CrossRefPubMed
18.
Siegenthaler A, Schliessbach J, Curatolo M, Eichenberger U. Ultrasound anatomy of the nerves supplying the cervical zygapophyseal joints: an exploratory study. Reg Anesth Pain Med. 2011;36:606–10.CrossRefPubMed
19.
Finlayson RJ, Gupta G, Alhujairi M, Dugani S, de Tran QH. Cervical medial branch block: a novel technique using ultrasound guidance. Reg Anesth Pain Med. 2012;37:219–23.CrossRefPubMed
20.
Finlayson RJ, Etheridge JP, Tiyaprasertkul W, Nelems B, de Tran QH. A prospective validation of biplanar ultrasound imaging for C5-C6 cervical medial branch blocks. Reg Anesth Pain Med. 2014;39:160–3.CrossRefPubMed
21.
Siegenthaler A, Mlekusch S, Trelle S, Schliessbach J, Curatolo M, Eichenberger U. Accuracy of ultrasound-guided nerve blocks of the cervical zygapophysial joints. Anesthesiology. 2012;117:347–52.CrossRefPubMed
22.
Finlayson RJ, Etheridge JP, Vieira L, Gupta G, de Tran QH. A randomized comparison between ultrasound- and fluoroscopy-guided third occipital nerve block. Reg Anesth Pain Med. 2013;38:212–7.CrossRefPubMed
23.
Siegenthaler A, Eichenberger U. Ultrasound-guided Third Occipital Nerve and cervical medial branch nerve blocks. In: Narouze SN, editor. Atlas of ultrasound- guided procedures in interventional pain management. 1st ed. New York: Springer; 2011. p. 107–17.CrossRef
24.
Kirpalani D, Mitra R. Cervical facet joint dysfunction: a review. Arch Phys Med Rehabil. 2008;89:770–4.CrossRefPubMed
25.
International Spine Intervention Society. Cervical medial branch block. In: Bogduk N, editor. Practice guidelines for spinal diagnostic and treatment procedures. San Francisco: International Spinal Intervention Society; 2004. p. 112–37.
26.
Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manip Physiol Ther. 1991;14:409–15.
27.
Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract. 2003;3:310–6.CrossRefPubMed
28.
McCarthy MJ, Grevitt MP, Silcocks P, Hobbs G. The reliability of the Vernon and Mior Neck Disability Index, and its validity compared with the short form-36 health survey questionnaire. Eur Spine J. 2007;16:2111–7.CrossRefPubMedPubMedCentral
29.
Manchikanti L, Manchikanti KN, Damron KS, Pampati V. Effectiveness of cervical medial branch blocks in chronic neck pain: a prospective outcome study. Pain Physician. 2004;7:195–202.PubMed
30.
Manchikanti L, Damron KS, Cash KA, Manchukonda R, Pampati V. Therapeutic cervical medial branch blocks in managing chronic neck pain: a preliminary report of a randomized, double-blind, controlled trial: Clinical TrialNCT0033272. Pain Physician. 2006;9:333–46.PubMed
31.
Grenier B, Castagnera L, Maurette P, Erny P, Senegas J. Chronic cervico-brachial neuralgia treated by cervical epidural injection of corticosteroids. Long-term results. Ann Fr Anesth Reanim. 1995;14:484–8.CrossRefPubMed
32.
Hayashi N, Weinstein JN, Meller ST, Lee HM, Spratt KF, Gebhart GF. The effect of epidural injection of betamethasone or bupivacaine in a rat model of lumbar radiculopathy. Spine. 1998;23:877–85.CrossRefPubMed
33.
Lee HM, Weinstein JN, Meller ST, Hayashi N, Spratt KF, Gebhart GF. The role of steroids and their effects on phospholipase A2. An animal model of radiculopathy. Spine. 1998;23:1191–6.CrossRefPubMed
34.
Johansson A, Hao J, Sjolund B. Local corticosteroid application blocks transmission in normal nociceptive C-fibres. Acta Anaesthesiol Scand. 1990;34:335–8.CrossRefPubMed
35.
Fishman SM, Smith H, Meleger A, Seibert JA. Radiation safety in pain medicine. Reg Anesth Pain Med. 2002;27:296–305.CrossRefPubMed
36.
Narouze SN. Ultrasound-guided cervical spine injections: ultrasound “prevents” whereas contrast fluoroscopy “detects” intravascular injections. Reg Anesth Pain Med. 2012;37:127–30.CrossRefPubMed
37.
Cohen SP, Strassels SA, Kurihara C, Forsythe A, Buckenmaier 3rd CC, McLean B, et al. Randomized study assessing the accuracy of cervical facet joint nerve (medial branch) blocks using different injectate volumes. Anesthesiology. 2010;112:144–52.CrossRefPubMed
38.
Narouze SN, Vydyanathan A, Kapural L, Sessler DI, Mekhail N. Ultrasound-guided cervical selective nerve root block: a fluoroscopy-controlled feasibility study. Reg Anesth Pain Med. 2009;34:343–8.CrossRefPubMed
39.
Huntoon MA. Anatomy of the cervical intervertebral foramina: vulnerable arteries and ischemic neurologic. Pain. 2005;117:104–11.CrossRefPubMed
40.
Finlayson RJ, Etheridge JP, Tiyaprasertkul W, Nelems B, de Tran QH. A randomized comparison between ultrasound- and fluoroscopy-guided C7 medial branch block. Reg Anesth Pain Med. 2015;40:52–7.CrossRefPubMed
41.
Narouze SN. Ultrasound-guided interventional procedures in pain management: evidence-based medicine. Reg Anesth Pain Med. 2010;35:S55–8.CrossRefPubMed
42.
Tiso RL, Cutler T, Catania JA, Whalen K. Adverse central nervous system sequelae after selective transforaminal block: the role of corticosteroids. Spine J. 2004;4:468–74.CrossRefPubMed
43.
Derby R, Lee SH, Date ES, Lee JH, Lee CH. Size and aggregation of corticosteroids used for epidural injections. Pain Med. 2008;9:227–34.CrossRefPubMed
44.
Souzdalnitski D, Lerman I, Halaszynski TM. How to improve needle visibility. In: Narouze SN, editor. Atlas of ultrasound-guided procedures in interventional pain management. 1st ed. New York: Springer; 2011. p. 35–75.CrossRef
45.
Gray AT. Ultrasound-guided regional anesthesia: current state of the art. Anesthesiology. 2006;104:368–73.CrossRefPubMed
46.
Marhofer P, Greher M, Kapral S. Ultrasound guidance in regional anaesthesia. Br J Anaesth. 2005;94:7–17.CrossRefPubMed
Metadaten
Titel
Ultrasound versus fluoroscopy-guided cervical medial branch block for the treatment of chronic cervical facet joint pain: a retrospective comparative study
verfasst von
Ki Deok Park
Dong-Ju Lim
Woo Yong Lee
JaeKi Ahn
Yongbum Park
Publikationsdatum
04.11.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 1/2017
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-016-2516-2

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