CT-guided spinal nerve root adhesiolysis for refractory atypical symptoms in cervical disc herniation: a retrospective cohort study.

OBJECTIVE

To evaluate the clinical efficacy and safety of CT-guided spinal nerve root adhesiolysis in treating refractory atypical symptoms-specifically dizziness and tinnitus-in patients with cervical disc herniation (CDH).

METHODS

This retrospective cohort study included 256 patients with CDH presenting with persistent atypical symptoms who had failed conservative therapy for at least 3 months. All patients underwent CT-guided periradicular adhesiolysis involving the injection of an ozone-oxygen mixture, normal saline, and corticosteroids. Primary outcomes included symptom alleviation rates and functional improvements assessed via the Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS) for pain, and Neck Disability Index (NDI) at 1, 3, 6, and 12 months post-procedure.

RESULTS

At the 12-month follow-up, the intervention demonstrated significant efficacy. The alleviation rate for dizziness (baseline prevalence 85.2%) was 80.3%, and for tinnitus (baseline prevalence 68.8%) was 75.6%. Statistically significant improvements were observed in all functional scores compared to baseline (P < 0.001). Specifically, DHI scores decreased from 65.2 ± 12.5 to 18.7 ± 6.0, and THI scores decreased from 58.7 ± 11.3 to 18.0 ± 5.8. 8 Subgroup analysis of patients with isolated dizziness or tinnitus confirmed efficacy independent of neck pain relief. The procedure showed a favorable safety profile with no serious adverse events.

CONCLUSION

For patients with CDH-related atypical symptoms refractory to conservative management, CT-guided spinal nerve root adhesiolysis is a safe and effective minimally invasive intervention. It provides sustained functional improvement and represents a vital therapeutic option for this challenging patient population.