Medial branch block versus cervical retrolaminar block in cervical facet joint arthropathy: A randomized, controlled trial

Document Type : Original Article

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mansoura university

Abstract

Background and objectives: Chronic posterior neck pain known to be caused by cervical facet joints (CFJ) arthropathy in 54% to 67% of the cases. Cervical medial branch nerve neurolysis or blocks (CMBB) and intraarticular injections have used for reducing neck pain caused by facet joint arthropathy. This randomized clinical trial aimed to compare between the efficacy and safety of cervical retrolaminar block (CRB) versus CMBB in the management of the CFJ pain.
Methods: Seventy patients were divided into 2 groups randomly: CMBB group in which CMBB was done at the level of the affected dermatome and one level above giving dexamethasone 1 mL and 1% lidocaine 0.5 mL in each level, whereas CRB group, cervical retrolaminar block (CRB) was done giving dexamethasone 2 mL and 1% lidocaine 3 mL for each dermatomal level affected . For all patients numerical rating score (NRS) was done before the block, 2 weeks, 2 and 3 months after (in which 0= no pain, 10 =worst pain). NDI (Neck Disability Index) was carried out prior to the block and 2 weeks after. Complications were also monitored.
Results: No statistically significant difference between the studied groups in NRS and NDI however they both improve in the two groups. The approach time was longer in CMBB group, whereas the vascular injury was lower in CRB group.
Conclusions: Cervical retrolaminar block has the same efficacy as CMBB in CFJ pain management, improved NDI, less time of procedure with no significant adverse events.

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