Clinical Study On The Treatment Of Cervical Spondylotic Radiculopathy By Two Different Puncture Routes Guided By B-ultrasound

BackgroundWith the progress of society and the development of science and technology,the popularity of mobile phones and computers has greatly changed the way of people’s life.With the incidence of cervical vertebral disease rising,more and more young people suffer from it,especially cervical spondylotic radiculopathy(CSR)disease which is the most common,accounting for 60 to 70% of cervical vertebral disease.The course of CSR disease is long and symptoms is serious,which affect the patient’s life and work.Nowdays,there is no simple,safe and effective treatment for CSR disease.This study is to explore the treatment of CSR disease under B-ultrasound guided treatment efficacy and safety for the benefit of patients.ObjectiveTo compare the clinical effects of b-ultrasound guided cervical paravertebral nerve block and nerve root block in the treatment of CSR.Provide reference for clinical treatment.MethodUpon the approval of the hospital medical ethics committee,select our hospital from May 2018 to May 2019,92 cases of patients with cervical spondylosis of nerve root type as the research object,uses the digital meter is divided into two groups,46 cases of vertebral nerve block set by using ultrasound guided nerve block to treat the cervical vertebra,nerve root block group of 46 patients with nerve root blockage therapy under ultrasound guidance,comparing two groups of narcotic drug dosage,efficacy,symptoms improved after treatment,record adverse reactions during the treatment.Results1.Baseline data: 2 patients in the paravertebral nerve block group received incomplete treatment and follow-up,and 1 patient in the nerve root block group received incomplete treatment and follow-up.There were no statistically significant differences in gender,course of disease,age,physiological curvature change,intervertebral foramina stenosis,bone spur compression on nerve root or intervertebral disc degeneration in the two groups(P > 0.05).2.Pain relief: there was no significant difference in VAS score between the two groups before treatment(P > 0.05).VAS scores in both groups were significantly lower after treatment than before treatment,and the differences were statistically significant(P < 0.05).VAS score improvement in nerve root block group was better than that in paravertebral block group,and the difference was statistically significant(P < 0.05).3.Improvement of cervical spine dysfunction: after the course of treatment,the pain intensity,lifting heavy objects,reading,personal care,concentration,headache,sleep,recreation,work,driving score and total score of the two groups were all lower than before the treatment,and the difference was statistically significant(P < 0.05).The pain intensity,lifting weight score and total score in the nerve root block group after treatment were all lower than those in the paravertebral block group,with statistically significant differences(P < 0.05).4.Efficacy: there was no statistically significant difference in quantitative scores of symptoms between the two groups before treatment(P > 0.05).The quantitative scores of symptoms in the two groups at the end of 1 course of treatment,4 weeks after the end of the course of treatment,and 8 weeks after the end of the course of treatment were significantly higher than those before the treatment,and the differences were statistically significant(P < 0.05).The quantitative scores of symptoms in the nerve root block group were higher than those in the paravertebral nerve block group at the end of 1 course of treatment,4 weeks and 8 weeks after the course of treatment,with statistically significant differences(P < 0.05).The total effective rates of the nerve root block group were 97.78%,97.78% and 97.78% at the end of one course of treatment,4 weeks and 8 weeks after the end of the course of treatment,respectively,which were higher than 86.36%,86.36% and 84.09% in the paravertebral nerve block group,with statistically significant differences(P < 0.05).5.Drug dosage: ropivacaine and compound betamethasone in the nerve root block group were lower than those in the paravertebral block group,with statistically significant differences(P < 0.05).6.Adverse reactions: the incidence of adverse reactions was 8.88% in the nerve root block group and 36.36% in the paravertebral block group,with statistically significant difference(P < 0.05).There were no cases of drugs strayed into blood vessels or subarachnoid space.ConclusionB-mode ultrasound-guided nerve root block treatment CSR puncture success rate is high for pain,cervical dysfunction patients,the incidence of adverse reaction is better than cervical paravertebral nerve block.