Background: Patients complaining cervical radiculopathy due to multilevel pathology on
imaging studies are still associated with moderate surgical outcome results. Although
multilevel surgery may result in an initially ‘‘good’’ surgical outcome; these patients
have a higher predisposition to pseudarthrosis and adjacent-level degeneration due to
loss of normal biomechanics.
Aim of the work: Evaluation of the role of US-guided selective nerve root block (SNRB) for
prediction of clinical outcome after selective anterior cervical discectomy & fusion
(ACDF) in patients with multilevel cervical disc disease.
Patients and Methods: This study is a prospective study conducted on 30 patients with
multilevel cervical disc disease presented to Benha University hospitals and Tanta
university hospital, meeting the inclusion criteria of the study. They had undergone
selective ACDF after using US-guided SNRB as a diagnostic tool for detecting the affected
root/roots.
Results: Guided by the results of the nerve root block, 20 cases were operated for single
level while the other 10 cases were operated for 2 levels. Arm pain visual analogue scale
(VAS) was reduced in all cases to 0-2 (except in one case). We found that the correlation
between SNRB results and the level/ levels with the most severe degree of MRI
degeneration was 80% and level/levels decided by neurological deficits/dermatome
radicular pain distribution were 36%.
Conclusions: selected ACDF following US guided SNRB, gives an excellent surgical
outcome. Indicating the higher the predictive value of US guided SNRB. |
