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Detection Rate of Intravascular Injections during Cervical Medial Branch Blocks: A Comparison of Digital Subtraction Angiography and Static Images from Conventional Fluoroscopy

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Author(s)
Young Hoon JeonSae Young Kim
Keimyung Author(s)
Kim, Sae Young
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
Korean Journal of Pain
Issued Date
2015
Volume
28
Issue
2
Keyword
ComplicationsDigital subtraction angiographyFluoroscopyMedial branchNeck painSpineZygapophyseal joint
Abstract
Background

The most definitive diagnosis of neck pain caused by facet joints can be obtained through cervical medial branch blocks (CMBBs). However, intravascular injections need to be carefully monitored, as they can increase the risk of false-negative blocks when diagnosing cervical facet joint syndrome. In addition, intravascular injections can cause neurologic deficits such as spinal infarction or cerebral infarction. Digital subtraction angiography (DSA) is a radiological technique that can be used to clearly visualize the blood vessels from surrounding bones or dense soft tissues. The purpose of this study was to compare the rate of detection of intravascular injections during CMBBs using DSA and static images obtained through conventional fluoroscopy.


Methods

Seventy-two patients were included, and a total of 178 CMBBs were performed. The respective incidences of intravascular injections during CMBBs using DSA and static images from conventional fluoroscopy were measured.


Results

A total of 178 CMBBs were performed on 72 patients. All cases of intravascular injections evidenced by the static images were detected by the DSAs. The detection rate of intravascular injections was higher from DSA images than from static images (10.7% vs. 1.7%, P < 0.001).


Conclusions

According to these findings, the use of DSA can improve the detection rate of intravascular injections during CMBBs. The use of DSA may therefore lead to an increase in the diagnostic and therapeutic value of CMBBs. In addition, it can decrease the incidence of potential side effects during CMBBs.

Keywords: Complications, Digital subtraction angiography, Fluoroscopy, Medial branch, Neck pain, Spine, Zygapophyseal joint
Keimyung Author(s)(Kor)
김세영
Publisher
School of Medicine
Citation
Young Hoon Jeon and Sae Young Kim. (2015). Detection Rate of Intravascular Injections during Cervical Medial Branch Blocks: A Comparison of Digital Subtraction Angiography and Static Images from Conventional Fluoroscopy. Korean Journal of Pain, 28(2), 105–108. doi: 10.3344/kjp.2015.28.2.105
Type
Article
ISSN
2005-9159
DOI
10.3344/kjp.2015.28.2.105
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34602
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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