Application value of Ultrasound-Guided cervical nerve root block test before percutaneous nucleoplasty in the treatment of patients with cervical chest pain: A retrospective study

Abstract

Purpose: Cervical chest pain (CCP) is an atypical symptom of cervical spine disease that often overlaps with other chest-related diseases but a type of noncardiogenic chest pain. The obvious relief of CCP after selective cervical nerve root block (SCNRB) near intervertebral disc herniation under ultrasound guidance should be considered to help identify the potential pathological source.The purpose of this study was to explore the application value of a positive ultrasound-guided SCNRB test before percutaneous cervical nucleoplasty (PCN) in the treatment of patients with CCP.

Methods: A retrospective analysis of 66 patients with CCP who underwent PCN was conducted. Patients were divided into a control group (PN group, n = 32) and an ultrasound-guided group (UPN group, n = 34) according to the absence or presence of ultrasound-guided SCNRB before surgery. The visual analogue scale (VAS) score, neck disability index (NDI), Pittsburgh Sleep Quality Index (PSQI), and proportion of patients taking oral analgesics before and at 1 week, 1 month, 3 months, and 6 months after surgery were recorded. The clinical effect according to the Odom criteria was recorded 6 months after surgery. The occurrence of adverse events was recorded to evaluate safety.

Results: Compared with baseline, both groups showed significant improvement in VAS score, NDI, and PSQI at 1 week, 1 month, 3 months, and 6 months after surgery (P < 0.05). The proportion of patients taking oral analgesics sharply decreased at each time point after surgery. The VAS score, NDI, and PSQI at 1 week, 1 month, 3 months, and 6 months after surgery in the UPN group were lower than those in the PN group, and the Odom criteria rate of excellent and good performance in the UPN group was 91.2%, which was significantly greater than that in the PN group at 75.0% (P < 0.05).

Conclusions: PCN can effectively alleviate the severity of chest pain, and improve sleep quality in patients with CCP. A positive ultrasound-guided SCNRB test before PCN can play a guiding role in identifying diseased nerves to improve the clinical efficacy of PCN in the treatment of CCP and can serve as a clinical reference.

Keywords: Angina; Cervical; Chest pain; Nerve block; Nucleoplasty; Ultrasound-guided.