Radiofrequency Plus Superficial Cervical Plexus Block in Treatment of Cervical Spondylosis Pain
NCT ID: NCT06480175
Last Updated: 2024-06-28
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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RECRUITING
NA
53 participants
INTERVENTIONAL
2024-06-20
2024-12-31
Brief Summary
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The main question it aims to answer is:
does adding superficial cervical plexus block to radiofrequency in patients with chronic neck pain provide better analgesia than radioprequency alone ?
Detailed Description
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The entry sites will be detected under fluoroscopy then local anesthesia will be performed using lidocaine 2% followed by the insertion of the radiofrequency cannula (STRYKER 20 G, 9 cm with 1 cm active tip) targeting the medial branches supplying C4, C5, C6 \& C7 bilateral.
the investigators will use 1 entry site for each side and then redirect the needles .
Confirmation of the appropriate location will be done on fluoroscopy in both A-P and lateral views Once targeted, sensory stimulation will be done and every patient is asked if he feels the same pain as that he used to suffer from. Once confirmed with absence of motor response; 1 more ml of lidocaine 20 % is injected and then start our ablation for 180 sec at 80 degrees
The procedure will be done bilateral the same. After 2 weeks , patient will be readmitted and then the investigators will choose to inject the superficial cervical plexus with 5 ml of lidocaine 20% plus 40 mg triamcinolone. injection was random in the right or left side using ultrasound to confirm success.
The side of the block will be recorded for each patient either right or left. Comparison will be done between both sides to study the effect of adding superficial plexus block to radio-frequency whether the analgesic effect is better on the side of radio frequency alone or the side where the superficial cervical plexus block was added to radio-frequency.
The patients will then be asked to be followed up after 1 month and after 6 months and about the improvement in the numeric pain score (NPS) and the patient global impression of change (PGIC) and if they feel that one side is better than the other or they feel the same. Visual analogue score scale will be recorded for documentation.
Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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cervical plexus block
patients will receive cervical radiofrequency nerve ablation on both sides and after 2 weeks will be readmitted and will receive superficail cervical plexus block on only one side
cervical plexus block
patients will receive cervical radiofrequency ablation on both sides then after 2 weeks they will be readmitted and will receive superficial cervical plexus block on one side only
Interventions
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cervical plexus block
patients will receive cervical radiofrequency ablation on both sides then after 2 weeks they will be readmitted and will receive superficial cervical plexus block on one side only
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Age between 30-70 years.
* American society of anesthesiologist ASA 1,2 \& 3 physical status.
* MRI cervical spine diagnosing cervical facet arthropathy originating pain .
* Failed full dose medical treatment and life style modification and physiotherapy for 3 months prior to intervention.
Exclusion Criteria
* coagulopathy INR \> 1.8 or platelets \< 50,000.
* Infection at or near the injection site.
* Presence of pacemaker or defibrillator.
* known allergy to used medications.
* age \>70 or \<30 years.
* patients with previous history of Radiotherapy , chemotherapy or metastasis
* pregnant patients.
* patients with rheumatological disorders ( rheumatoid arthritis, diffuse idiopathic skeletal hyerostosis, psoriatic arthritis, spondyloarthritis)
* patients with antiphospholipid syndtrome.
30 Years
70 Years
ALL
No
Sponsors
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Ain Shams University
OTHER
Responsible Party
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Lydia edward aziz zakhary
lecturer
Principal Investigators
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lydia zakhary, MD
Role: PRINCIPAL_INVESTIGATOR
Ain Shams University
Locations
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Ain Shams University Hospital
Cairo, , Egypt
Countries
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Central Contacts
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Facility Contacts
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lydia E zakhary
Role: primary
References
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Berger AA, Liu Y, Mosel L, Champagne KA, Ruoff MT, Cornett EM, Kaye AD, Imani F, Shakeri A, Varrassi G, Viswanath O, Urits I. Efficacy of Dry Needling and Acupuncture in the Treatment of Neck Pain. Anesth Pain Med. 2021 Apr 3;11(2):e113627. doi: 10.5812/aapm.113627. eCollection 2021 Apr.
Burnham T, Conger A, Salazar F, Petersen R, Kendall R, Cunningham S, Teramoto M, McCormick ZL. The Effectiveness of Cervical Medial Branch Radiofrequency Ablation for Chronic Facet Joint Syndrome in Patients Selected by a Practical Medial Branch Block Paradigm. Pain Med. 2020 Oct 1;21(10):2071-2076. doi: 10.1093/pm/pnz358.
Other Identifiers
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neck pain
Identifier Type: -
Identifier Source: org_study_id