Selective Nerve Root Block With Ultrasound Guidance Improves Surgical Outcome of Selective Discectomy in Patients With Multilevel Cervical Disc Disease

Study Overview
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Brief Summary
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Disc degeneration is a natural part of growing older. Up to 60% of asymptomatic people have MRI findings that are positive. As a result, MRI only provides morphological information and may not be able to determine the clinical significance of the findings.

Detailed Description
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Many authors believe that patients who suffer from cervical radiculopathy as a result of degenerative disease and have multilevel pathology on imaging studies still have moderate surgical outcomes. This occurs due to a misdiagnosis or the need to perform surgery on multiple levels despite a single painful lesion. Although the complication rate for 1- and 2-level ACDF is so low that it is considered one of the safest procedures in spine surgery. There is concern that increasing levels of fusion will lead to more complications, such as a higher incidence of persistent axial neck pain, dysphagia, and vertebral artery injury, as well as more postoperative pain and higher narcotic dosages.

Official Title
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Selective Nerve Root Block With Ultrasound Guidance Improves Surgical Outcome of Selective Discectomy in Patients With Multilevel Cervical Disc Disease: a Randomized Controlled Trial

Conditions
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Selective Nerve Root Block, Selective Discectomy

Intervention / Treatment
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* Procedure: selective anterior cervical discectomy and fusion (ACDF)
* Procedure: SNRB+ selective anterior cervical discectomy and fusion (ACDF)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all patients presented with unilateral brachialgia due to multilevel cervical disc disease Exclusion Criteria: multilevel cervical disc disease who had bilateral brachialgia, myelopathy, double crush syndrome, ossified posterior longitudinal ligament (OPLL), combined anterior and posterior pathology requiring posterior decompression

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group C<br>selective anterior cervical discectomy and fusion (ACDF) | Procedure: selective anterior cervical discectomy and fusion (ACDF)<br>* selective anterior cervical discectomy and fusion (ACDF)<br>|
| Experimental: Group SNRB<br>US-guided selective nerve root block (SNRB) then selective anterior cervical discectomy and fusion (ACDF) | Procedure: SNRB+ selective anterior cervical discectomy and fusion (ACDF)<br>* US-guided selective nerve root block (SNRB) + selective anterior cervical discectomy and fusion (ACDF)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain intensity | Visual analogue score (VAS): 0= no pain, 10= worst pain | 24 hours postoperative |