Therapy of a symptomatic cervical perineural cyst with ultrasound-guided cervical selective nerve root block: A case report.
Medication (Baltimore). 2018 Sep;97(37):e12412
Authors: Lee J, Kim Okay, Kim S
RATIONALE: Symptomatic cervical perineural cysts are extraordinarily uncommon, they usually trigger radicular ache by compressing the cervical nerve root. A number of strategies have been utilized to handle the radicular ache induced by cervical perineural cysts, together with treatment, percutaneous procedures, and surgical procedure. Nevertheless, these strategies are related to numerous outcomes and issues. The percutaneous process is straightforward and straightforward to carry out, but when the perineural cyst wall is punctured, it may well result in secondary issues, which embody aseptic meningitis and intracranial hypotension.
PATIENT CONCERNS: A 51-year-old girl introduced with a uninteresting ache within the left shoulder and a tingling sensation within the left dorsal arm, hand, and center finger.
DIAGNOSIS: The affected person was recognized with left C7 radicular ache brought on by a perineural cyst.
INTERVENTIONS: The left C7 radicular ache didn’t reply to therapy with treatment. Due to this fact, a left C7 nerve root block with native anesthetics and steroids was carried out below ultrasound steerage. Adjunctively, real-time fluoroscopy with distinction was used to keep away from intravascular injection.
OUTCOME: The signs resolved with none issues.
LESSONS: On this case, perineural cyst-induced radicular ache, which was immune to treatment, was handled utilizing ultrasound guided cervical selective nerve root block with native anesthetics and steroids. Ultrasound steerage can allow profitable cervical selective nerve root block with out perineural cystic wall puncture. Due to this fact, ultrasound-guided cervical nerve root block is an efficient therapy possibility for radicular ache brought on by a symptomatic perineural cyst.
PMID: 30213018 [PubMed – in process]