Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT05450926 |
Other study ID # |
Selective cervical root block |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
February 17, 2022 |
Est. completion date |
June 1, 2023 |
Study information
Verified date |
August 2023 |
Source |
Diskapi Teaching and Research Hospital |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Currently, selective cervical nerve root injections are recommended under the guidance of
fluoroscopy, ultrasonography and computed tomography in patients with chronic cervical
radicular pain who do not respond to conservative treatments and are not planned for surgery.
Various serious complications, mainly vascular, have been reported in the literature. These
complications include vertebral artery injury, spinal cord and brain stem infarction. The
arteries of the cervical spinal cord are the vertebral, ascending, and deep cervical arteries
arising from the aorta.The arteries arising from these main arteries and reaching the
intervertebral foramen are called segmental arteries, the arteries reaching the epidural
region from the intervertebral foramen and the radicular arteries, and the branches reaching
the spinal cord are called the medullary artery. These small arteries supplying the spinal
cord lie close to the spinal nerve in the foramen between the anterior and posterior
trabercules. Vasospasm or embolism, which occurs as a result of direct needle trauma to these
vascular structures around the target nerve or injection of particulate steroids, are the
most common causes of complication development.
The aim of our study is to identify the vascular structures around the foramen in selective
cervical root injection, which has proven effectiveness in cervical radicular pain, to
determine the most reliable method for positioning the needle while reaching the target nerve
under US guidance and to prevent possible complications.
Description:
A total of 50 healthy volunteers and 10 patients with cervical radicular pain, between the
ages of 18-70, height above 155 cm and body mass index 25 and below, in the Algology Clinic
of the University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital
will be included in the study. Those who have structural disorders in the neck region and who
have undergone neck surgery will not be included in the study. 7 cadavers will be included in
the study in Ankara University Faculty of Medicine, Department of Anatomy.
2 Algology specialists from Health Sciences University Dışkapı Yıldırım Beyazıt Training and
Research Hospital Algology Clinic and 3 doctors from Ankara University Medical Faculty
Anatomy Department will participate in the study. Two Algology Specialists will record the
localization and number of cervical spinal nerve, transverse process cornes and surrounding
vascular structures at cervical C4-5-6-7 levels in healthy volunteers by Doppler USG. Again,
two Algology Specialists will apply cervical root block to patients with cervical radicular
pain guided by Doppler USG, and pain scores of the patients will be evaluated with VAS
(visual analog scale) before and after the procedure. Seven formalin-containing human
cadavers will be examined by 3 anatomy doctors at Ankara University Faculty of Medicine,
Department of Anatomy to determine the morphology of the spinal nerve, vertebral artery,
assending and deep arteries in the cervical foraminal region, as well as the radicular
arteries.
Demographic characteristics (age, gender, BMI, body height) of 50 volunteers and 10 patients
with cervical radicular pain will be recorded. The pain intensity of 10 patients with
cervical radicular pain will be determined and recorded with the VAS (visual analog scale)
score before the procedure and at 1,2,3 and 4 weeks after the procedure, by calling the
patients for control.
The cadavers will be dissected after being placed in the supine position and bilaterally from
C4 to C7. Neurovascular complexes will be defined.
Efforts will be made to determine the most appropriate needle pathway to reach the target
cervical nerve.