Stellate ganglion block versus cervical epidural steroid injection for cervical radiculopathy: a comparative-effectiveness study

Abstract

© American Society of Regional Anesthesia & Pain Medicine 2022. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Cervical epidural steroid injection (CESI) and stellate ganglion block (SGB) are often performed as a treatment for cervical radicular pain. 2 Both can improve blood flow by sympathetic blockade, despite weak evidences demonstrating a sympathetic component to patients with cervical radicular pain. Although fluoroscopyguided CESI is recommended to prevent serious adverse events, concerns have been raised regarding radiation exposure. SGB is now more commonly performed using ultrasound due to good imaging of soft tissues and bony surfaces and no risk of radiation. 5 Despite mention of the effectiveness of SGB on cervical radicular pain in case reports or observational studies with fewer than 20 patients, randomized, controlled, comparative trials are lacking. Therefore, we evaluated and compared the effectiveness of fluoroscopyguided CESI and ultrasoundguided SGB in patients with unilateral cervical radicular pain.