Cervical Multifidus Fatty Degeneration and Bony Foraminal Stenosis Are Associated with Unsuccessful Response to Stellate Ganglion Block in Cervical Radicular Pain: A Retrospective Study.

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Τίτλος:	Cervical Multifidus Fatty Degeneration and Bony Foraminal Stenosis Are Associated with Unsuccessful Response to Stellate Ganglion Block in Cervical Radicular Pain: A Retrospective Study.
Συγγραφείς:	Kwon HJ; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea., Choi D; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea., Yi SW; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea., Lee JS; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea., Shin JW; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea., Choi SS; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea., Kim DH; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea., Kim CS; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.
Πηγή:	Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2026 Jun 05; Vol. 62 (6). Date of Electronic Publication: 2026 Jun 05.
Τύπος έκδοσης:	Journal Article
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: MDPI Country of Publication: Switzerland NLM ID: 9425208 Publication Model: Electronic Cited Medium: Internet ISSN: 1648-9144 (Electronic) Linking ISSN: 1010660X NLM ISO Abbreviation: Medicina (Kaunas) Subsets: MEDLINE
Imprint Name(s):	Publication: 2018- : Basel, Switzerland : MDPI Original Publication: Kaunas : Lietuvos gydytojų sąjunga
Ιατρικοί όροι (MeSH):	Stellate Ganglion/drug effects , Stellate Ganglion/physiopathology , Paraspinal Muscles/physiopathology , Paraspinal Muscles/pathology , Autonomic Nerve Block/methods , Radiculopathy, Nerve Block/methods ; Humans ; Retrospective Studies ; Female ; Middle Aged ; Male ; Logistic Models ; Aged ; Treatment Outcome ; Ultrasonography, Interventional ; Adult ; Cervical Vertebrae
Περίληψη:	Background and Objectives: Ultrasound-guided stellate ganglion block is a promising alternative intervention for cervical radicular pain. However, factors associated with treatment responses remain unknown. This single-center, retrospective study aimed to identify clinical and radiological factors associated with treatment response to stellate ganglion block in patients with cervical radicular pain. Materials and Methods: This study included patients with cervical radicular pain who underwent ultrasound-guided stellate ganglion block. Successful response was defined as a ≥4-point or ≥50% reduction in the numerical rating scale score at 3 months post-procedure compared with the pre-procedural baseline. Patients who did not meet these criteria or underwent additional interventional procedures for persistent cervical radicular pain within 3 months were classified as unsuccessful responders. Logistic regression analysis was performed to identify factors associated with treatment response. Results: Multivariable logistic regression analysis demonstrated that substantial cervical multifidus fatty degeneration, defined as Goutallier grade ≥2 of the cervical multifidus muscles (vs. minimal fatty degeneration, odds ratio (OR) 0.23, 95% confidence interval (CI): 0.08-0.66, p = 0.007) and bony hypertrophy at the uncovertebral or facet joint as the primary etiology of foraminal stenosis (vs. disc herniation, OR 0.35, 95% CI: 0.14-0.87, p = 0.024) were independently associated with lower odds of a successful response to stellate ganglion block. Steroid use was not significantly associated with treatment response (OR 0.52, 95% CI: 0.18-1.49, p = 0.223). The successful response rate declined progressively with the number of risk factors: 94.7% (18/19), 50.0% (22/44), and 40.7% (11/27) for zero, one, and two factors, respectively (p < 0.001). Conclusions: Substantial cervical multifidus fatty degeneration and foraminal stenosis attributable to bony hypertrophy may be associated with lower odds of a successful response to stellate ganglion block in patients with cervical radicular pain. These factors require prospective validation before routine clinical implementation.
Grant Information:	20023168 Ministry of Trade, Industry and Energy; RS-2025-02216928 Ministry of Science and ICT
Contributed Indexing:	Keywords: hyperostosis; nerve block; pain management; paraspinal muscles; risk factors; stellate ganglion; ultrasonography, interventional
Entry Date(s):	Date Created: 20260626 Date Completed: 20260626 Latest Revision: 20260726
Update Code:	20260726
PubMed Central ID:	PMC13303820
DOI:	10.3390/medicina62061097
PMID:	42356110
Βάση Δεδομένων:	MEDLINE

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Περιγραφή
ISSN:	1648-9144
DOI:	10.3390/medicina62061097