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