Comparison of the analgesic efficacy of ultrasound guided two nerve blocks in patients with chronic neck pain.
- Conditions
- Medical and Surgical,
- Registration Number
- CTRI/2023/10/059336
- Lead Sponsor
- Jawaharlal Institute of Postgraduate and Medical Research
- Brief Summary
Cervical radiculopathy is a common condition that usually results from compression and inflammation of the cervical nerve root or roots in the region of the neuralforamen. The clinical manifestations are broad and may include pain, sensory deficits, motor deficits, diminished reflexes, or any combination of the above. Nonoperative treatment of cervical radiculopathy consists of a number of different modalities including immobilization, physical therapy, traction, manipulation,medication, and cervical steroid injection.
Cervical Epidural Steroids Injection are being used in patients with less improvements with non-invasive conservative therapies. Most commonly used Epiduralsteroid injections are Fluoroscopic guided Transforaminal Epidural Steroid Injections and Fluoroscopic guided Inter Laminar Epidural Steroid Injections. Studiescomparing Fluoroscopic guided techniques and Ultrasound guided Selective Nerve Root block found no statistically significant difference in clinicalefficacy. Ultrasound guided Selective Nerve Root Block is associated with less intravascular injection rate and similar pain relief.
Real time Ultrasound guidance helps in Identification of critical vessels at unexpected locations relative to the Intervertebral foramen and avoiding injuryto such vessels, Better identification of anatomical structures, Real time visualization of drug spread and Shorter duration of procedure. It also has noRadiation exposure and functional improvements compared to Fluoroscopic guided Epidural Steroid Injections. The Ultrasound guided Retrolaminar Cervical Block has shown promising results in reduction of Cervical radicular pain and it may be considered safer thanEpidural Steroid Injections as it does not require entering into the neuraxis.
There are no available RCTs, in literature, that have compared the effects of these two modalities among Indian population. In our study, we propose to find thedifference and compare the clinical efficacy and adverse effects of Ultrasound guided Selective Nerve Root Block versus Ultrasound guided Retrolaminar Cervicalblock in patients with Chronic Cervical Radiculopathy. The results of this study will help us to choose an ideal intervention technique for patients with ChronicCervical radiculopathy.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- All
- Target Recruitment
- 64
Consenting Patients having Cervicogenic neck pain with etiology of either cervical disc herniation or cervical stenosis for more than 3 months with VAS score of greater than 6 despite conservative management.
- 1.Cardiopulmonary disease 2.
- Severe cervical stenosis who requires surgical management 3.
- Patients withPrimary shoulder pathology, neurological deficits, Cervical Myelopathyor cervical nerve root compression other than disc herniation including tumor or stenosis.
- Those with previous spine surgeries or previous epidural steroid within 3 months duration.
- Bleeding disorders 6.Allergy to study drugs 7.
- Local infection 8.
- Cervical radiculopathy having motor symptoms 9.
- Psychiatric disorders.
- Lab results suggestive of Inflammatory disease or rheumatoid arthritis.
- Pregnancy/lactation.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method To compare the Numerical Rating Scale(NRS) score among the patients receiving Ultrasound guided Selective Nerve Root Block Versus Ultrasound guided Retrolaminar Cervical Block in patients with Cervical Radiculopathy. Pre intervention | Post intervention day 0 | Post intervention day 1 | Post intervention day 7 | Post intervention week 2 | Post intervention month 1 | Post intervention month 3 | Post intervention month 6
- Secondary Outcome Measures
Name Time Method Neck disability Index(NDI) Pre intervention Quality of Life using the 12 item short form survey (SF-12) Pre intervention Pain free days(using Calender method) Pre intervention 1.Duration and Ease of administration. 2.Adverse events related to the block such as Intravascular, Intraneural injection will be noted
Trial Locations
- Locations (1)
Jawaharlal Institute of Postgraduate Medical Education and Research
🇮🇳Pondicherry, PONDICHERRY, India
Jawaharlal Institute of Postgraduate Medical Education and Research🇮🇳Pondicherry, PONDICHERRY, IndiaDr Siddani Jaya Sai Satya SivaniPrincipal investigator7680820646satyasivanisiddani@gmail.com