1. 2024;27;161-168Cervical Nerve Root Block Using a Curved Blunt Needle and Posterior Approach
   Retrospective Review
   Carl Noe, MD, Michael van Hal, MD, Standiford Helm II, MD, and Gabor B. Racz, MD.

BACKGROUND: Cervical transforaminal epidural steroid injections have become less popular due to the risk of catastrophic complications they pose. However, cervical nerve root blocks are useful for surgical planning in patients with cervical radicular pain syndromes.

OBJECTIVES: Our aim was to find a method of performing cervical selective nerve root blocks that removed the risk of catastrophic complications.

STUDY DESIGN: Retrospective case review.

SETTING: Academic multidisciplinary spine center.

METHODS: Among patients, 50 consecutive cases were retrospectively reviewed for immediate pain scores and follow-up results. In the intervention, a posterior approach using a curved blunt needle was employed for cervical selective nerve root blocks to minimize the risk of arterial injection. To measure the outcomes, we used quantitative pain severity scores and qualitative responses.

RESULTS: This technique detailed in this study has a high immediate analgesic effect that can be used for diagnostic purposes. It is not known if this technique has prognostic value with respect to surgery. The prolonged response rate is about 50%, which is in line with other techniques.

LIMITATIONS: This study had no control group.

CONCLUSION(s): Cervical selective nerve root blocks using a curved blunt needle and a posterior approach are effective in selectively identifying nerves that cause clinical symptoms. This technique minimizes the risk of arterial or spinal cord impingement and therefore may be safer than transforaminal selective nerve root blocks.

KEY WORDS: Cervical radiculitis, cervical radiculopathy, cervical radicular pain, cervical foraminal stenosis, cervical disk herniation, cervical stenosis, cervical selective nerve root block, cervical transforaminal steroid injection