Exploring the therapeutic potential of ultrasound-guided nerve hydrodissection: a comprehensive retrospective analysis

Abstract

Aim

To determine the efficacy of ultrasound-guided nerve hydrodissection for the clinical improvement of commonly entrapped peripheral nerves.

Materials and methods

A retrospective review of patient information was conducted for the period of Jan 2015-Dec 2020. Potential patients were identified using a keyword search for ‘hydrodissection’ and/or ‘perineural injection’ from radiology reports. Data included patient age, sex, intervention date, target peripheral nerve, pre-intervention clinical presentation, electromyography (EMG) data and patient outcomes at 3 weeks, 3 months and 6 months post-procedure. Outcomes included pain (as rated on the visual analog scale, 1–10), numbness, tingling, paraesthesias, mobility and others. The data were used to assess intervention efficacy based on each peripheral nerve as well as total peripheral nerves.

Results

Data were collected for 204 patients for various peripheral nerves. At the 3-week follow-up, 48% demonstrated minimal improvement, 18% demonstrated moderate improvement and 34% demonstrated significant improvement. At the 3-month follow-up, 52% demonstrated minimal improvement, 20% demonstrated moderate improvement and 28% demonstrated significant improvement. Finally, at the 6-month follow-up, 56% demonstrated minimal improvement, 14% demonstrated moderate improvement and 30% demonstrated significant improvement.

Conclusion

Moderate to significant clinical improvement was noted in half of the patients and minimal improvement in the remaining half of the patients who had undergone ultrasound-guided nerve hydrodissection. To date, there are few studies assessing the effectiveness of ultrasound-guided hydrodissection. These results therefore have implications for the use of this dynamic, percutaneous, ultrasound-guided intervention using steroid and local anaesthetic for multiple peripheral nerves.