The Specificity of Cervical Facet Medial Branch Blocks

Not Applicable

Completed

• Conditions: Neck Pain; Cervical Facet Arthropathy
• Interventions: Procedure: Cervical medial branch blocks

• Registration Number: NCT00613340
• Lead Sponsor: Johns Hopkins University

Brief Summary

Cervical facet arthropathy is a common cause of chronic neck pain. The "gold standard" for diagnosis is either blocking the facet joints, or more commonly blocking the medial branch nerves that innervate the joints. However, many studies have found a high false-positive rate when the nerves are blocked using 0.5 ml of local anesthetic. We will randomize patients to receive either cervical facet medial branch blocks with 0.25 ml of local anesthetic and contrast, or 0.5 ml. We will then do a CT scan to determine the accuracy and specificity of each block. Our hypothesis is that using the higher volume (0.5 ml) might be responsible for the high false-positive rate.

Detailed Description

Inclusion criteria: Dept. of Defense beneficiaries \> 18 years of age; neck pain \> 3 months duration; cervical paraspinal tenderness Exclusion criteria: Radicular signs or symptoms; use of anticoagulants or bleeding disorder.

Outcome measures: The number of blocks whereby the contrast bathes the target nerve; the number of blocks whereby the contrast spreads to the medial branch nerve at the adjacent spinal level; the number of times the contrast diffuses into the intervertebral foramen or epidural space. We will also compare pain relief over 8 hours following the block between both volumes.

Study Timeline

• Study Start: 2008-01
• Study First Submitted: 2008-01-31
• Study First Submitted QC: 2008-02-12
• Study First Posted: 2008-02-13
• Primary Completion: 2009-04
• Study Completion: 2009-04
• Status Verified: 2009-08
• Last Update Submitted: 2009-08-05
• Last Update Posted: 2009-08-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• Age > 18 years
• Chronic neck pain > 3 months
• Paraspinal tenderness

Exclusion Criteria

• Absence of radicular symptoms
• No bleeding diathesis
• Contrast allergy

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
1	Cervical medial branch blocks	Cervical medial branch blocks with 0.25 ml of injectate
2	Cervical medial branch blocks	Cervical medial branch blocks with 0.5 ml of local anesthetic and contrast

Primary Outcome Measures

Name	Time	Method
Accuracy of injections	Immediately after nerve blocks.

Secondary Outcome Measures

Name	Time	Method
Pain relief after nerve blocks	8 hours after blocks

Trial Locations

Locations (1)

Walter Reed Army Medical Center; 🇺🇸 Washington, District of Columbia, United States