A Novel Transverse Ultrasound-Guided Approach for Puncturing the Cervical Dorsal Root Ganglion at the Level of Articular Pillar for Radiofrequency Treatment

Jinyu Lai,1 Yijun Wu,2 Yong Xiang,1  Yun Wang3 1Department of Pain, Taihe Hospital, Hubei University of Medicine, Hubei, People’s Republic of China; 2Department of Radiology, Taihe Hospital, Hubei University of Medicine, Hubei, People’s Republic of China; 3Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Yun Wang, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China, Tel +86-10-13521611825, Email [email protected] Yong Xiang, Department of Pain,Taihe Hospital, Hubei University of Medicine, Hubei, 442000, People’s Republic of China, Tel +86-719-13972451941, Email [email protected]: Currently, minimally invasive intervention surgery for cervical spondylotic radiculopathy mostly involves the use of cervical dorsal root ganglion (DRG) block or radiofrequency modulation therapy. Here, we proposed a novel transverse ultrasound-guided approach for puncturing the cervical dorsal root ganglion at the level of joint column for radiofrequency treatment.Patients and Methods: A retrospective analysis of the clinical data of 30 patients with cervical spondylotic radiculopathy admitted to the Pain Department of Taihe Hospital Affiliated with Hubei Medical University from January 2021 to March 2024 was performed. During surgery, motor electrical stimulation was used to induce movement in the nerve-innervated area, and the relationship between the puncture needle tip and the cervical DRG position was verified using a C-arm X-ray machine. The numerical rating scale (NRS) was used for preoperative and postoperative pain assessment, clinical treatment effectiveness was evaluated, surgical duration and the associated complications were also recorded.Results: Thirty patients exhibited clear cervical DRG images under ultrasound guidance, and the punctures were successful in all patients. Motor electrical stimulation induced movement in the corresponding nerve innervation area in the range of 0.3– 0.8 mv in all patients. No serious complications occurred during the procedure.Conclusion: The transverse ultrasound-guided approach for puncturing the cervical dorsal root ganglion at the level of joint column for radiofrequency treatment is effective, convenient, and safe.Keywords: ultrasound guidance, neck DRG, cervical spondylotic radiculopathy, pulse RF