The Study Of Cervical Nerve Root Block Treatment Of Cervicogenic Pain And The Effects Of Peripheral T Lymphocytes

Objective: To observe the treatment effects of cervicogenic pain byultrasound-guided cervical selective nerve root block and analysis theimmunologic mechanism of action.Method:23cases of cervical discogenic pain (CDP) withultrasound-guided cervical selective nerve root block treatment (test group,group A) and23cases of CDP with X-ray C-arm guided cervical paravertebralblock treatment (control group, group B) were collected from January2013toJanuary2014. Evaluate the treatment effects by numerical rating scale (NRS),range of the motion in the neck (ROM)，weekly pain episodes, duration of painepisodes and the subjective relief rate of cervical stiff before and aftertreatment. The count of T lymphocyte subsets CD3+, CD4+and CD8+werechecked before and after treatment24h,1day and3days by flow cytometry(FCM) in the peripheral blood of all patients.Results:（1）About the treatment effects, group A and group B after7daystreatment compared with before treatment, NRS after treatment decreased to3.67±3.23and4.67±3.45from the score of before treatment (7.08±2.00and6.96±2.11, respectively)（P<0.01）; Weekly pain episodes, decreased to3.23±3.17and4.57±3.55from before treatment (11.08±17.77and9.66±12.46)（P<0.05）; The duration of pain episodes, decreased to3.57±3.53h and4.47±3.75h from the time of7.55±6.44h and8.08±7.45h that before treatment（P<0.05）; ROM scores decreased to1.51±0.63and1.48±0.51from thescores of2.69±2.12and2.93±2.11（P<0.05）; The subjective relief rate ofcervical stiff decreased to26.09%and52.17%from86.96%and91.30%（P<0.05）.(2) About the immunologic mechanism of action, group A and group B after treatment compared with before treatment, the count of Tlymphocyte subsets CD3+, CD4+and CD8+were increased after treatment24h,3day and7days, respectively（P<0.01or P<0.05）in group A; CD3+,CD4+and CD8+were increased after treatment24h and3day（P<0.01orP<0.05）in group B.(3) NRS, weekly pain episodes and the subjective reliefrate of cervical stiff were lower significantly in group A compared with group B（P<0.05）；The amount of T lymphocyte subsets CD3+, CD4+and CD8+werehigher significantly in group A compared with group B（P<0.05）.Conclusion: The method of cervical nerve root block by ultrasound guidedwas proved to have a significant effect on cervicogenic pain treatment, and itwas better than the method of cervical paravertebral block. The immunologicmechanism may be related to the regulation of the count of T lymphocytesubsets CD3+, CD4+and CD8+in the peripheral blood so that to enhance thecellular immunity function of patients.