Accuracy and efficacy of ultrasound‐guided puncture (vs. computed tomography‐guided) in cervical medial branch blocks for cervicogenic pain: A randomized controlled study

Abstract

AbstractCervical medial branch block (CMBB) has been recognized as an effective treatment for cervicogenic pain. Previous studies mostly used ultrasound‐guided out‐of‐plane puncture for CMBB, while this prospective study was designed to investigate the efficacy of ultrasound‐guided in‐plane puncture, specifically focusing on the new target of CMBB for cervical pain. This study includes two parts: the accuracy study (N = 15, CMBB was completed by ultrasound and confirmed by computed tomography [CT], in which a good distribution percentage of the analgesic solution was observed) and the efficacy study (N = 40, CMBB was completed by ultrasound or CT, while the proportion of pain relief (numerical rating scale) decrease by more than 50% postoperatively was analyzed). The results showed that the good distribution percentage of the analgesic solution was 97.8%. Furthermore, in the early period (30 min and 2 h postoperatively), the proportion of patients with pain relief was lower in the ultrasound group than that in the CT group, especially at 2 h postoperatively (52% vs. 94%). However, at 24 h postoperatively and later, the proportion of patients with pain relief gradually stabilized to about 60%–70%, and lasted for about 2 weeks to 1 month. Therefore, the new target for CMBB, guided by ultrasound in‐plane, offers high visibility and accuracy. A single CMBB performed under ultrasound guidance resulted in pain relief comparable to that of a CT‐guided procedure (1 day to 1 month postoperatively). This study indicated that CMBB guided by ultrasound in‐plane could be regarded as a promising approach for treatment of cervicogenic pain.