Successful Pain Relief by Local Injection Under Ultrasound Guidance in a Patient with Anatomical Abnormality of Cervical
- PDF / 556,879 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 72 Downloads / 153 Views
IMAGES IN PRACTICE
Successful Pain Relief by Local Injection Under Ultrasound Guidance in a Patient with Anatomical Abnormality of Cervical 5 Nerve Root Daqiang Zhao . Hong Zhang . Jian Chen . Tao Xu
Received: May 8, 2020 Ó The Author(s) 2020
Keywords: Anatomical abnormality; Cervical nerve root; Pain; Therapy; Ultrasound guidance Key Summary Points The incidence of nerve root anomalies is 14%, the L5–S1 level being most commonly involved. As a result of agerelated changes, the exiting spinal nerves in the cervical spinal region are also frequently affected, or are approached because of cervical osteochondrosis or disc herniation management. Anomalies of the nerve roots often produce pain in the corresponding innervation. Sometimes, ultrasound is a valuable tool to depict an anatomical abnormality.
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12452435. D. Zhao H. Zhang T. Xu (&) Department of Anesthesiology, Tongzhou People’s Hospital, Nantong 226300, China e-mail: [email protected] D. Zhao Department of Anesthesiology, Jiahui International Hospital, Shanghai 200233, China J. Chen (&) Department of Orthopaedics, Tongzhou People’s Hospital, Nantong 226300, China e-mail: [email protected]
The C5 nerve travels abnormally alongside the anterior edge of the anterior scalene muscle and may induce perception which distributes across the right backside of the neck and shoulder, with radiating pain to the right upper arm. Under ultrasound guidance, bolus injection of 2 ml 0.15% ropivacaine plus Diprospan 2.5 mg mixture to the C5 nerve root anterior to the anterior scalene muscle could relieve the shoulder and upper arm pain. During the second visit, the patient complained that some back pain remains on the medial scapula area. Under ultrasound guidance, the dorsal scapular nerve was found to touch the posterior tubercle of the C6 transverse process. Bolus injection of 0.25% ropivacaine 2 ml plus 10% glucose 3 ml to the dorsal scapular nerve totally relieved the pain. The C5 nerve bypasses the anterior edge of the scalenus muscle, and the dorsal scapular nerve may also be distributed abnormally and close to the posterior tubercle of the transverse process of C6. Frequent friction of the nerve causes pain in the medial part of the scapula. T. Xu Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
Pain Ther
CASE The incidence of nerve root anomalies is 14% [1], the L5–S1 level being most commonly involved. As are result of age-related changes, the exiting spinal nerves in the cervical spinal region are also frequently affected, or are approached because of cervical osteochondrosis or disc herniation management. Anomalies of the nerve roots often produce pain in the corresponding innervation. Sometimes, ultrasound is a valuable tool to depict an anatomical abnormality [1]. The cervical 5 (C5) nerve travels abnormally alongside the anterior edge of the anterior scalene muscle and may induce p
Data Loading...
