Abstract

Object: This pilot study aimed to evaluate the effectiveness of cervical epidural block (CEB) in improving upper extremity muscle strength in individuals diagnosed with cervical disc herniation.
Materials and Methods
5 patients diagnosed with cervical disc herniation were included and underwent a single CEB treatment. Patients were monitored weekly for 2 weeks via an outpatient clinic. Hand grip strength of affected side and difference of hand grip strength between affected and unaffected side (DHGS) was recorded using dynamometers; before treatment, immediate after treatment, after 1week and 2weeks of treatment. Pain on neck and radiating pain to upper extremity (UE) were measured using the visual analogue scale (VAS) before treatment and 2weeks after treatment.
Results
The median age of the patients was 48 (37.0-78.0) years, and the affected disc levels were C5-6 (3 patients), C6-7 (1 patient), and C5-6-7 (1 patient) respectively. In terms of pain, VAS of neck decreased from 6.8 to 3.2, and VAS of UE decreased from 7.4 to 3.0. Both hand grip strength of affected side and DHGS showed improvement when comparing before and after treatment (immediate, 1 week and 2 weeks after treatment) (p<0.001). However, there was no difference between immediate, 1 week and 2 weeks after treatment. The result was same for adjusting age and sex as covariates (p<0.001).
Conclusions
These findings suggest that CEB has the potential in improving pain and UE muscle weakness associated with cervical disc herniation. Further large-scale studies are necessary to validate these preliminary outcomes and establish the long-term effectiveness and sustainability of CEB in managing cervical disc herniation.

• Keywords: Cervical disc herniation, Epidural block, Dynamometer, Handgrip strength, Visual analogue scale