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OpenTrials
Completed

NCT Number: NCT07476235

Predictors of Treatment Response to Stellate Ganglion Block in Cervical Radicular Pain

Purpose: Stellate ganglion block (SGB) is a procedure that uses ultrasound to guide a needle near a group of nerves in the neck called the stellate ganglion. A local anesthetic is then injected to block pain signals. This procedure has recently shown promise as a treatment for cervical radicular pain - pain that travels from the neck down into the arm, usually caused by a pinched nerve in the spine.

While SGB appears to be effective for many patients, not all patients respond equally well. Currently, there is no way to predict before the procedure which patients are likely to benefit and which are not. Identifying such predictors would help doctors select the right patients for this treatment and avoid unnecessary procedures.

Study Question: This study aimed to determine whether specific clinical characteristics or imaging findings on MRI could predict whether a patient would have a successful pain response after receiving SGB for cervical radicular pain.

Methods: This was a retrospective study that reviewed the medical records of patients who received ultrasound-guided SGB at a single medical center between October 2018 and April 2023. Patients were included if they had one-sided arm pain caused by a pinched nerve confirmed on MRI and had not improved after at least one month of standard treatments such as medication and physical therapy.

Information collected from medical records included patient age, sex, body mass index, presence of diabetes or hypertension, pain severity (measured on a 0-to-10 scale), duration of symptoms, and neck disability scores. Imaging findings from cervical MRI were also evaluated, including the degree of nerve compression, the cause of the compression (soft disc herniation versus bony overgrowth), the condition of the spinal canal, disc degeneration, and the amount of fatty changes in the small muscles along the back of the neck (called the multifidus muscles).

Hypothesis: The study hypothesized that certain imaging-based factors - specifically, significant fatty degeneration of the cervical multifidus muscles and bony overgrowth as the main cause of nerve compression - would be associated with a poorer response to SGB at 3 months after the procedure.

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Key information

Conditions

Radiculopathy, Cervical Region Nervous System Diseases Neuromuscular Diseases Peripheral Nervous System Diseases Radiculopathy

Age range

19 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Asan Medical Center

Seoul, 05505, South Korea

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Unilateral cervical radicular pain
  • Evidence of cervical foraminal stenosis on magnetic resonance imaging (MRI) consistent with radicular pain
  • Age ≥ 19 years
  • Symptoms unresponsive to at least 1 month of conservative treatment, including medication and physical therapy

Exclusion criteria

  • History of cervical spine surgery
  • Bilateral symptoms or involvement of three or more segments
  • Neck pain intensity greater than arm-pain intensity
  • Other conditions, such as facet joint syndrome or myofascial pain syndrome, contributing to the symptoms
  • Insufficient documentation in the electronic medical records

Treatment and study plan

Cervical multifidus fatty degeneration

Other

Cervical multifidus fatty degeneration was assessed by evaluating the degree of fatty infiltration in the bilateral multifidus muscles at the C5-C6 level, which is a region noted for its high mechanical load and flexibility, rendering it susceptible to degenerative changes.T2-weighted axial MRI images were analyzed, and fatty infiltration of the cervical multifidus muscle was graded using the Goutallier classification as follows: grade 0 (no fat signal), grade 1 (minimal fat signal), grade 2 (more muscle than fat), grade 3 (equal amounts of fat and muscle), and grade 4 (more fat than muscle) (Fig. 1). For the analysis, cervical multifidus fatty degeneration was defined as minimal (Goutallier grades 0-1) or substantial (Goutallier grades 2-4).

Primary etiology of foraminal stenosis

Other

The primary etiology of foraminal stenosis was determined by differentiating between disc herniation and bony hypertrophy at the uncovertebral or facet joint, based on the more prominent lesion.

Steroid use during stellate ganglion block

Drug

Use of dexamethasone 5 mg added to 6 mL of 1% lidocaine versus 1% lidocaine alone during ultrasound-guided stellate ganglion block, based on the treating physician's clinical decision.

Other collected data

Other

Other collected data included patient demographics, such as age, sex, body mass index, and comorbidities, including diabetes and hypertension, pre-procedural symptoms such as radicular pain with or without neck pain, neck disability index, pain duration, cervical curvature types, central stenosis grade, foraminal stenosis grade, and disc degeneration.

Primary outcomes

  1. Successful response

    Time frame: At 3 months post-procedure

    Successful response was defined as either a reduction of ≥4 points on the numerical rating scale or a ≥50% decrease in pain intensity at 3 months post-procedure.

Sponsors and collaborators

Lead sponsor

Asan Medical Center

Other

Registry information

Official study title

Cervical Multifidus Fatty Degeneration and Bony Foraminal Stenosis Predict Unsuccessful Response to Stellate Ganglion Block in Cervical Radicular Pain: a Retrospective Study

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Mar 17, 2026
Registry last updated
Mar 18, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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