Surgical cervical level selection guided by diagnostic root block; a single arm pilot study.

Abstract

Purpose: Assessment of the clinical results of selective anterior cervical discectomy and fusion (ACDF) guided by nerve root block (SNRB) under US guidance in patients with multilevel cervical disc disease.Methods: This prospective study was carried out on thirty patients who met the study's inclusion criteria and were diagnosed with multilevel cervical disc disease at our university hospital. Following the application of US-guided SNRB as a diagnostic test to identify the afflicted root or roots, they had gone through selective ACDF.Results: Twenty cases had surgery for a single level, while the remaining ten cases underwent surgery for two levels, according to the nerve root block results. With one exception, all cases saw a reduction in the arm pain NRS (numeric rating scale) to 0–2. We discovered that there was an 80% association between the results of the SNRB and the level or levels with the highest degree of MRI degeneration and a 36% correlation between the level or levels determined by neurological deficits/dermatome radicular pain distribution.Conclusions: The superior predictive value of US-guided SNRB is demonstrated by the excellent surgical outcome of selected ACDF guided by the results of US-guided SNRB.