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Selective Cervical Nerve Root Blockade: Prospective study of immediate and longer term complications. 2008

Interventional Spine

Ronald S Pobiel, MD,
Sharad Chopra, MD, Non ASSR Member
John A Eklund, MD, ASSR Member
Marshall J Golden, MD, Non ASSR Member
Blake A Johnson, MD, ASSR Member
Kurt P Schellhas, MD, ASSR Member

Scientific Paper

Purpose

To prospectively evaluate the safety of outpatient fluoroscopically-guided diagnostic and therapeutic selective cervical nerve root blockade (SCNRB).

Methods & Materials

Over 500 consecutive fluoroscopically-guided diagnostic and/or therapeutic extraforaminal SCNRB were performed using an anterior, oblique approach during an 11 month period. Each case was performed by one of seven procedural radiologists, all experienced in, and actively performing spinal injections on a fulltime basis in clinical practice. Nonionic contrast was injected in all cases, and a minimum of two projection filming was performed to document accuracy of needle placement and contrast dispersal prior to the injection of therapeutic substances. All patients were assessed for complications 30 minutes following the procedure and were attempted contact by telephone approximately 4 weeks following the procedure to assess for immediate and delayed complications.

Results

There were no serious complications, such as stroke, spinal cord insult, or permanent nerve root deficit. There were minor complications, such as vasovagal reaction, transient Horner's syndrome and increased pain.

Conclusion

Outpatient fluoroscopically guided SCNRB is a safe procedure when performed with meticulous technique by physicians experienced with spinal injections.

References

K.P. Schellhas, S.R. Pollei, B.A. Johnson, M.J. Golden, J.A. Eklund, and R.S. Pobiel: Selective Cervical Nerve Root Blockade: Experience with a Safe and Reliable Technique Using an Anterolateral Approach for Needle Placement
AJNR Am. J. Neuroradiol., first published on Sep 28, 2007 as doi: doi:10.3174/ajnr.A0707