The Ultrasound-guided Selective Nerve Root Injections in the Lower Cervical Spines

Objective: To introduce the technique of the ultrasound- guided selective nerve root injection in the lower cervical spine and to evaluate its accuracy and distribution patterns of injections. Method: Thirty-one patients with the cervical radiculopathies (C5 to C7) from cervical disc herniation were enrolled in this study. Targeted nerve root image was obtained and the needle was introduced to its dorsal surface under the ultrasound guidance. Then 2 ml of contrast media was injected which was followed by fluoroscopic image. The accurate injection was defined as the contrast media placed over the neural foramen along the targeted nerve root. Results: 24 of 31 (77.4%) procedures were assesed to be accurately placed and there was no significant complication. The accuracy of injection was lower at the C7 nerve root (70.0%) than other nerve roots. In all cases, large amount of back flow to the brachial plexus and spread to the adjacent nerve roots were observed. Conclusion: In the lower cervical spines, ultrasound-guided selective nerve root injections might be considered as a radiation free, safe and available method. (J Korean Acad Rehab Med 2008; 32: 619-623)