Cervical neuralgia
Conditions
Interventions
Control group:Ultrasound guidance + transverse process anterior and posterior intertubercular approach
Test grou:Ultrasound guidance + intervertebral foraminal approach
Sponsors
Affiliated Hospital of Jiangsu University
Eligibility
Sex/Gender
All
Age
18 Years to 90 Years
Inclusion criteria
Inclusion criteria: 1. Meet the diagnostic criteria of cervical neuralgia: manifested as pain in the upper back of the neck and shoulders with radiating pain in the upper limbs (involving the C4~C7 innervation area), with or without mild hypesthesia of the upper limbs, and cervical spine MRI/CT confirms the existence of cervical nerve root compression, intervertebral foraminal stenosis, or peri-nerve root inflammation. 2. Duration of the disease >= 1 month: no significant pain relief after >= 2 weeks of standardised conservative treatment (including oral non-steroidal anti-inflammatory drugs, neurotrophic drugs, physiotherapy, etc.), which is in line with the timing of minimally invasive therapeutic intervention. 3. Pain level up to the standard: NRS>=4 points, and pain affects daily life (such as sleep, daily activities are limited), with a clear need for analgesic treatment. 4. Age 18-90 years old: taking into account the safety and efficacy of treatment for adult patients, excluding the immature development of the cervical spine in minors and the lack of tolerance in elderly patients (>90 years old). 5. Imaging assessment is suitable for puncture: ultrasound and MRI/CT examination of the cervical spine show clear anatomical structures of the anterior and posterior cervical transverse processes and intervertebral foramina, with no serious bony deformities (e.g., severe scoliosis, vertebral compression fracture), and no abnormal variations of vertebral vascular routes to ensure that the two approaches are feasible for puncture operation. 6. Normal cognition and cooperation ability: no mental disease or cognitive impairment, able to clearly express pain perception and treatment response, and able to cooperate with preoperative assessment, intraoperative stimulation test and postoperative follow-up.
Exclusion criteria
Exclusion criteria: 1. Contraindications related to puncture: including abnormal coagulation function (prolonged prothrombin time, platelet count <80×10?/L), skin or soft tissue infection at the puncture site, active systemic infection; combined with severe cardiopulmonary dysfunction (such as heart failure, acute exacerbation of chronic obstructive pulmonary disease), liver and kidney failure, and inability to tolerate interventional procedures. 2. Cervical anatomical abnormalities or serious lesions: cervical spine tumors, tuberculosis, cervical spine instability (such as lumbar spondylolisthesis above grade II), or severe stenosis of the intervertebral foramen (anterior and posterior diameter <4mm). 3. Severe impairment of neurological function: combined with spinal cord injury (such as muscle strength <=grade 3), severe peripheral neuropathy (such as diabetic peripheral neuropathy involving the upper limbs). 4. Special groups: Pregnant or lactating women; allergic to local anesthetics and materials related to radiofrequency treatment; long-term use of anticoagulants (such as warfarin, new oral anticoagulants) with discontinuation of <7 days (increased risk of bleeding). 5. Previous cervical nerve interventional treatment history: Have received cervical nerve root radiofrequency, nerve block or spinal cord electrical stimulation treatment, which may have residual treatment effects and interfere with the comparison of the efficacy of the two approaches in this study. 6. The painful area is only myofasciitis: The painful area is diagnosed as simple myofascial inflammation, and the cervical nerve involvement segment does not meet the imaging diagnosis.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| NRS score changes;NDI score changes;Positioning time;Number of punctures; | — |
Secondary
| Measure | Time frame |
|---|---|
| PSQI (Pittsburgh Sleep Quality Inde)scale score;Odom's Criteria grading;Incidence of adverse reactions; | — |
Countries
China
Contacts
Public ContactLi Chunye
Affiliated Hospital of Jiangsu University
Outcome results
None listed