Ultrasound-guided Selective Cervical Nerve Root Block Combined With Drugs In The Treatment Of Cervical Spondylotic Radiculopathy

Objective: To investigate the efficacy of ultrasound-guided cervical selective nerve root block combined with drugs in the treatment of cervical spondylotic radiculopathy.Methods: 50 patients who were diagnosis of cervical spondylotic radiculopathy(CSR)were selected as the research objects.They were divided into observation group and control group by random number table method,25 cases in each group.The control group(group A)was treated with oral pregabalin(PGB)、celecoxib(CLB)and duloxetine(DLX).combined with clinical manifestations and MRI results of the patients,the experimental group(group B)was treated with ultrasound-guided selective cervical nerve root block,and oral medication and other treatments were the same as group A.The numerical rating scale(NRS)and emotional scale(ES)were observed and evaluated before treatment and 3 days,1 weeks,2 weeks,4 weeks and 8 weeks after treatment.The Neck Disability Index(NDI)scores were recorded before and after treatment of the patients.The changes of vital signs of were recorded in group B before and after the treatment.The nerve root block and puncture complications were recorded in group B.The results of inflammatory indicators including the white blood cell count(WBC),neutrophil(NEU),C-reaction protein(CRP)and immune inflammatory factor interleukin-6(IL-6)and tumor necrosis factor(TNF-α)were recorded before and after treatment of the patients.Results: After treatment,the NRS and ES scores of the two groups were lower than those before treatment at day 3,week 1,week 2,week 4 and week 8(P<0.05);Compared with group A,group B had significantly lower NRS scores at day 3,week 1,week 2 and week 4 after treatment(P<0.05);After treatment,the NRS score of the group B was significantly lower than group A at week 8(P<0.01),the difference was statistically significant.There was no statistically significant difference in NDI scores between the two groups before treatment(P>0.05),which was comparable;After treatment,NDI scores in both groups were significantly lower than before(P<0.01),compared with group A,the NDI score of group B decreased more significantly after treatment(P<0.01),the difference was statistically significant.There was no significant difference in heart rate,blood pressure,respiration,pulse,blood oxygen saturation and other vital signs before and after treatment in group B(P >0.05).In group B,the number of patients anastomosed between the block plane and the innervated area of the lesion accounted for 84% after treatment,and there were no puncture adverse reactions such as pneumothorax,puncture site infection,local anesthetic poisoning,nerve root injury,and total spinal anesthesia.The inflammatory indexes WBC,NEU,CRP and immune inflammatory factors IL-6 and TNF-αwere significantly decreased in both groups compared with that before treatment(P<0.05).Compared with group A,the reduction in group B was more significant after treatment,and the difference was statistically significant(P<0.05).Conclusion: Ultrasound-guided selective cervical nerve root block combined with drugs can significantly kill the pain of patients with cervical spondylotic radiculopathy,alleviate anxiety,reduce the expression of immune inflammatory factors IL-6 and TNF-α,and reduce the inflammatory response of nerve roots.