Effect of nerve root block guided by ultrasound on cervicogenic pain and its influence on immune function.

ABSTRACT

Cervicogenic pain is a common chronic disease that needs individualized treatment according to the place of pain. This study aimed to observe the effect of ultrasound-guided nerve root block in the treatment of cervicogenic pain and its influence on immune function. A total of 30 patients (group A) with cervical discogenic pain (CDP) were treated by selective cervical nerve root block and 30 patients (group B) with CDP were treated with cervical spinal block under the X-ray C-arm guidance. The two groups of patients were examined with regard to the analgesic effect by Numerical Rating Scale (NRS), and the changes in the preoperative and postoperative range of motion in the neck (ROM). In addition, weekly pain attacks and the duration of each attack were recorded. The content of CD3+, CD4+ and CD8+ in the peripheral blood T lymphocyte subsets in the two groups was evaluated by flow cytometry. The levels of these subsets were compared 24 h before treatment, 24 h after treatment, 3 days (d) after treatment and 7 d after treatment. At the time periods of 24 h, 3 d, and 7 d after treatment, the NRS of the two groups decreased significantly compared with before treatment (P less than 0.01). The changes of the ROM, the number of weekly pain attacks, the duration of each pain attack, and the stiffness of the head and neck were significantly lower in the two groups compared with those prior to the treatment (P less than 0.05). In group A and group B, the number of CD3+, CD4+ and CD8+ T cells 24 h and 3 d after treatment increased significantly compared with that noted before treatment (P less than 0.05). Seven days after treatment, the levels of CD3+, CD4+ and CD8+ T cells in the peripheral blood T lymphocytes of group A were significantly higher than those of group B (P less than 0.05). Selective cervical nerve root block under ultrasound is an effective method for the treatment of cervical discogenic pain. The effect is better than that of the X-ray C-arm-guided cervical block method. The mechanism of selective cervical nerve root block under ultrasound may be related to the regulation of the content of CD3+, CD4+, CD8+ T cells in the peripheral blood T lymphocyte subsets and the enhancement of cellular immunity.