Ultrasound-guided nerve hydrodissection of cervical nerve roots for cervical radicular pain in patients with mild and moderate to severe stenosis: a retrospective cohort study

• Published in: Scientific reports 2023-08, Vol.13 (1), p.13817-13817, Article 13817
• Main Authors: Lin, Chang-Hao, Yen, Yun-Shan, Wu, Cheng-Yi
• Format: Article
• Language: English
• Subjects: 692/308; 692/308/409; Cohort analysis; Dextrose; Humanities and Social Sciences; Lidocaine; multidisciplinary; Neuropathy; Pain; Patients; Science; Science (multidisciplinary); Side effects; Stenosis; Ultrasonic imaging; Ultrasound
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-40376-2

Because fascial entrapment neuropathy can occur in multiple locations, ultrasound-guided nerve hydrodissection has become a key component of the treatment of cervical radicular pain. In this paper, we propose a combination of injectates used for nerve hydrodissection of the cervical nerve roots and compare the clinical outcomes of this treatment among patients with different severities of stenosis. This is a retrospective cohort study designed to compare outcomes between patients with mild stenosis and moderate to severe stenosis. Forty-four patients with mild cervical stenosis and 30 patients with moderate to severe cervical stenosis were consecutively enrolled into two groups. A 10-mL mixture in a single level consisting of 5% in Dextrose, 0.2% lidocaine (Xylocaine), and 4 mg betamethasone (Rinderon) was used for nerve roots hydrodissection. The two groups were compared with regard to their numeric rating scales (NRS) of pain, proportion of patients who exhibited a favorable outcome (a reduction of pain ≥ 50%), duration of patient exhibited a favorable outcome, and occurrence of serious complications and minor side effects. The follow-up period ranged from 3 to 20 months. The NRS of both groups improved significantly by 1 week, 1 month, 3 months, and final follow-up after the initial injection. Differences in the groups’ NRS, proportion of patients who exhibited a favorable outcome, duration of patient exhibited a favorable outcome , and occurrence of serious complications and minor side effects were nonsignificant. There were 4 patients (5.4%) experienced dizziness in that resolved without further treatment. Ultrasound-guided nerve hydrodissection of cervical nerve roots is a safe procedure that reduces pain associated with cervical radicular pain, even in patients with moderate to severe stenosis.