Initial evaluation of pain relief efficacy of ultrasound-guided selective nerve root injection with corticosteroid in the treatment of cervical disc herniation

Abstract

Objective: To evaluate the pain relief efficacy of selective nerve root injection with corticosteroid under ultrasound’s guidance in the treatment of the cervical disc herniation and its complications. Subject and method: The study was conducted with 20 cervical disc herniation patients in the Center of Multidisciplinary Consultation and Treatment, 108 Military Central Hospital from February 2021 to May 2021. All included patients were examined and performed the first injection, then observed for 2 hours after the procedure. The second injection would be indicated if the first one was not able to relieve 50% of pain at each time points of study. The time points of study were T₀, T_1, T₂, T₃ according to before, at a time, and after intervention 2 weeks and 4 weeks. The researched outcomes were vital signs, general status, Numeric Rating Scale (NRS, for pain assessment), and complications. Result: The average age of subjects was 54.75 ± 12.07 years old. Gender ratio (male/female) was 1.22. The most common herniated level was C5-C6 (90%), mainly right orientation (67%). The most frequent compressed nerve root was C6 right (67%). The NRS score at the time points after intervention significantly reduced, and this favorable outcome steadily maintained (p<0.05). The most popular complication was the parasympathetic reflex (10%), it gradually disappeared with conservative care. There was no severe complication. Conclusion: The selective nerve root injection with corticosteroid under ultrasound’s guidance in the treatment of cervical disc herniation is the acceptably safe and effective management.