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Distribution Patterns of the Vulnerable Vessels Around Cervical Nerve Roots

The aim of the study was to evaluate the prevalence of vulnerable
vessels around the target of cervical transforaminal epidural steroid injection
at the C3-C7 cervical nerve root levels in a clinical setting. DESIGN: Retrospective, cross-sectional study was conducted. PARTICIPANTS: Patients
complaining of neck or arm pain with no previous surgical history and who had
undergone both precontrast and contrast-enhanced neck computed tomography were
included retrospectively. RESULTS: In 26 (21.0%) of 124 patients, none of the
vulnerable vessels around the target of cervical transforaminal epidural steroid
injection around both sides of the C3-C7 nerve roots were observed. Of 248
cervical root levels, the C3 level had 103 vessels (41.5%), the C4 level had 110
vessels (44.4%), the C5 level had 98 vessels (39.5%), the C6 level had 59 vessels
(23.8%), and the C7 level had 34 vessels (13.7%) close to each target nerve root.
In addition, variations of the vertebral artery at the C4-C7 level were observed
in 11 (8.9%) of 124 patients. CONCLUSIONS: To prevent unexpected critical
complications involving injury to vulnerable vessels during cervical
transforaminal epidural steroid injection, it is recommended to routinely
evaluate the vulnerable vessels around the cervical nerve root with computed
tomography or Doppler ultrasound before cervical transforaminal epidural steroid
injection, especially for the upper cervical nerve root level.

Langue : ANGLAIS

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