The Specificity of Cervical Facet Medial Branch Blocks

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EstadoTerminado

Patrocinadores

Johns Hopkins University

Colaboradores

Army Regional Anesthesia and Pain Management Initiative

ENSAYO CLÍNICO: NCT00613340

BioSeek: nct00613340

Palabras clave

Abstracto

Cervical facet arthropathy is a common cause of chronic neck pain. The "gold standard" for diagnosis is either blocking the facet joints, or more commonly blocking the medial branch nerves that innervate the joints. However, many studies have found a high false-positive rate when the nerves are blocked using 0.5 ml of local anesthetic. We will randomize patients to receive either cervical facet medial branch blocks with 0.25 ml of local anesthetic and contrast, or 0.5 ml. We will then do a CT scan to determine the accuracy and specificity of each block. Our hypothesis is that using the higher volume (0.5 ml) might be responsible for the high false-positive rate.

Descripción

Inclusion criteria: Dept. of Defense beneficiaries > 18 years of age; neck pain > 3 months duration; cervical paraspinal tenderness Exclusion criteria: Radicular signs or symptoms; use of anticoagulants or bleeding disorder.

Outcome measures: The number of blocks whereby the contrast bathes the target nerve; the number of blocks whereby the contrast spreads to the medial branch nerve at the adjacent spinal level; the number of times the contrast diffuses into the intervertebral foramen or epidural space. We will also compare pain relief over 8 hours following the block between both volumes.

fechas

Verificado por última vez:	07/31/2009
Primero enviado:	01/30/2008
Inscripción estimada enviada:	02/11/2008
Publicado por primera vez:	02/12/2008
Última actualización enviada:	08/04/2009
Última actualización publicada:	08/06/2009
Fecha de inicio real del estudio:	12/31/2007
Fecha estimada de finalización primaria:	03/31/2009
Fecha estimada de finalización del estudio:	03/31/2009

Condición o enfermedad

Neck Pain

Cervical Facet Arthropathy

Intervención / tratamiento

Procedure: 1

Procedure: 2

Fase

Grupos de brazos

Brazo	Intervención / tratamiento
Experimental: 1 Cervical medial branch blocks with 0.25 ml of injectate	Procedure: 1 Cervical medial branch blocks done with 0.25 ml of local anesthetic and contrast
Experimental: 2 Cervical medial branch blocks with 0.5 ml of local anesthetic and contrast	Procedure: 2 Cervical medial branch blocks with 0.5 ml of local anesthetic and contrast

Criterio de elegibilidad

Edades elegibles para estudiar	18 Years A 18 Years
Sexos elegibles para estudiar	All
Acepta voluntarios saludables	si
Criterios	Inclusion Criteria: - Age > 18 years - Chronic neck pain > 3 months - Paraspinal tenderness Exclusion Criteria: - Absence of radicular symptoms - No bleeding diathesis - Contrast allergy

Salir

Medidas de resultado primarias

1. Accuracy of injections [Immediately after nerve blocks.]

Medidas de resultado secundarias

1. Pain relief after nerve blocks [8 hours after blocks]