Clinical Research Of Ultrasound-guided Selective Nerve Root Block In The Treatment Of Cervical Spondylotic Radiculopathy

Objective:Nerve block technology is widely used in the treatment of Cervical Spondylotic Radiculopathy(CSR),with the continuous improvement and progress of ultrasound technology,ultrasound-guided therapy has the advantage of visualization,so this topic mainly discusses whether there is a difference between the safety and clinical efficacy of ultrasound-guided block therapy and traditional block therapy in patients with CSR.At the same time,explore whether low-concentration anti-inflammatory analgesic solution can be used to achieve the therapeutic effect of high-concentration anti-inflammatory analgesics,improve the safety of diagnosis and treatment of CSR.The ultrasound guidance technology will be better promoted and applied in clinical work.Methods:A total of 80 patients with CSR admitted from May 2018 to January 2020 in the Pain Department of Yan'an Hospital of Kunming City,divided into ultrasound guided treatment group(A1 group,A2 group)and traditional anatomical positioning treatment group(B1 group,B2 group),20 cases in each group.Group A1 used 2.5ml of anti-inflammatory analgesic liquid containing 0.5%lidocaine,group A2 used 2.5ml of anti-inflammatory analgesic liquid containing 0.25%lidocaine,and group B1 used 2.5ml of anti-inflammatory analgesic liquid 2.5%lidocaine,group B2 used 2.5ml of anti-inflammatory analgesic solution containing 0.25%lidocaine.Observe the improvement of the Visual Analogue Scale(VAS)of the four groups of patients at one day and one week after operation,the number of treatments>2 cases,one month postoperative clinical efficacy and incidence of adverse reactions,statistics and analysis of the differences between the data.Results:(1)In terms of improvement in VAS scores:the four groups of patients at one day and one week after operation were significantly lower than their preoperative VAS scores(P<0.05);Comparison between different treatments at the same concentration(A1 and B1 groups,A2 and B2 groups),compared with the traditional block group,the ultrasound-guided group had a significantly lower VAS score at one day and one week after surgery(P<0.05);While comparing the same treatment methods at different concentrations(A1 and A2 groups,B1 and B2 groups),there was no significant difference in the reduction of VAS scores at one day and one week after operation in groups A1 and A2,B1 and B2(P>0.05).(2)Number of treatments>2 cases:the ultrasound-guided group(A1+A2 group)was significantly less than the traditional block group(B1+B2 group)in the number of secondary block cases(P<0.05).(3)One month postoperative clinical efficacy:ultrasoumn-guided group(A1+A2 group)is more effective than the traditional block group(B1+B2 group)(P<0.05);Comparison between the same treatment methods at different concentrations(A1 and A2 groups,B1 and B2 groups),there was no statistically significant difference in the efficacy of group A1 and A2,group B1 and group B1 in one month after operation(P>0.05).(4)In terms of the incidence of adverse reactions:the incidence of adverse reactions in the ultrasound-guided group(A1+A2 group)was lower than that in the traditional block group(B1+B2 group)(P<0.05);Compared with the same treatment method at different concentrations(A1 group and A2 group,B1 group and B2 group),there is no significant difference between A1 group and A2 group(P>0.05),the number of adverse reactions in group B1 was more than that in group B2(P<0.05).Conclusions:1.Ultrasound-guided nerve block treatment of CSR can clearly plan the puncture path than traditional blocking methods,avoiding the mistaken penetration of important blood vessels and nerves,and has a lower incidence of adverse reactions.2.Ultrasound-guided can selectively block cervical nerve roots,and the immediate effect is obvious,the pain relief and cervical spine mobility function are significantly improved after one month of operation,and the secondary block rate is significantly reduced.3.Ultrasound-guided precision treatment can not only reduce the concentration of local anesthetic drugs,but also achieve the effect of high-concentration drug treatment,which is worthy of popularization and application in clinical diagnosis and treatment.