The high thoracic erector spinae plane block (ESPB) has been used for the management of chronic shoulder pain or arthroscopic shoulder surgery. No study has evaluated the analgesic efficacy of ESPB in patients with cervical radiculopathy although it is a favored and easy technique compared to neuraxial block. The purpose of this study was to compare the treatment outcome of cervical radiculopathy using high thoracic ESPB or cervical interlaminar epidural injection (CEPI). Methods: This study included 82 patients with neck and arm pain who received CEPI (CEPI group) using 4 ml of 0.1% ropivacaine or high thoracic ipsilateral ESPB (ESPB group) at the T2 or T3 level using 20 ml of 0.1% ropivacaine 20 ml. The degree of pain relief and disability were assessed using an 11-point numerical scale (NRS) and neck disability index (NDI), respectively. Results: The CEPI and ESPB groups demonstrated an equal number of patients with excellent pain relief (NRS reduction ≥ 50%). Significant reduction of NRS was found in both groups, and the effect of time was statistically significant in the groups (P < 0.001). The number of patients who showed an excellent improvement in NDI (NDI reduction ≥ 30%) was 20 (48.8%) and 22 (53.7%) in the CEPI and ESPB groups, respectively. Conclusions: Both the CEPI and ESPB demonstrated significant relief in neck and arm pain with improvement in disability.

Radiofrequency thermocoagulation (RFT) via trans-oval approach is effective treatment modalities for trigeminal neuralgia. Clear identification of the foramen ovale (FO) is the most important initial step for successful percutaneous procedures. The purpose of this study was to verify whether the medial end of the temporomandibular joint and the distance between the mandibular angle and the occipital inner line can be used as a fluoroscopic landmark to determine the proper angulation of the C-arm. Analysis of previously saved fluoroscopic FO images during RFT was performed. As a fluoroscopic landmark to guide a proper lateral and axial oblique rotation of the C-arm, the position of the medial end of the temporomandibular joint and the vertical distance between the mandibular angle and the occipital inner line were evaluated. When the FO was located at the most central point within the H-figure, the medial end of TMJ was always located within the mandibular notch. The maximum view of the FO was defined when the FO showed maximal short axis to long axis ratio. The FO showed the best view when the vertical distance between the mandibular angle and occipital inner line was 20.04 (5.1) mm. This study demonstrated that the medial end of the temporomandibular joint and the vertical distance between the mandibular angle and occipital inner line as a fluoroscopic landmark for obtaining the optimal view of the FO.