Therapeutic selective nerve root block in the nonsurgical treatment of atraumatic cervical spondylotic radicular pain: A retrospective analysis with independent clinical review

Objective: To investigate the outcomes resulting from the use of fluoroscop ically guided therapeutic selective nerve root block (SNRB) in the nonsurgi cal treatment of atraumatic cervical spondylotic radicular pain. Study Design: Retrospective study with independent clinical review. Participants: Twenty subjects (10 men, 10 women) with mean age 56.6 years. Methods: Each patient met specific physical examination, radiographic, and electrodiagnostic criteria to confirm a level of cervical involvement. Thos e patients whose root level remained indeterminate were required to demonst rate a positive response to a fluoroscopically guided diagnostic SNRB prior to the initiation of treatment. Therapeutic injections were administered i n conjunction with physical therapy. Data collection and analysis were perf ormed by an independent clinical reviewer. Main Outcome Measures: Pain score, work status, medication usage, and patie nt satisfaction. Results: Twenty patients with an average symptom duration of 5.8 months wer e included. An average of 2.2 therapeutic injections was administered. Foll ow-up data collection transpired at an average of 21.2 months following dis charge from treatment. A significant reduction (p =.001) in pain score was observed at the time of follow-up. Medication usage was also significantly improved (p =.005) at the time of follow-up. An overall good or excellent r esult was observed in 60%. Thirty percent of patients required surgery. You nger patients were more Likely (p =.0047) to report the highest patient sat isfaction rating following treatment. Conclusions: This study suggests that fluoroscopically guided therapeutic S NRB is a clinically effective intervention in the treatment of atraumatic c ervical spondylotic radicular pain.