Cervical Medial Branch Block Versus Ipsilateral Cervical Erector Spinae Plane Block (CERVESP)

Ultrasound-Guided Cervical Medial Branch Block Versus Ipsilateral Cervical Erector Spinae Plane Block in Cervical Facetogenic Pain: A Prospective Randomized Controlled Study

This prospective randomized controlled study aims to compare the analgesic effectiveness of ultrasound-guided cervical medial branch block and ipsilateral cervical erector spinae plane block in patients with cervical facetogenic pain.

Patients with chronic cervical facet-mediated pain will be randomized into two intervention groups. Pain intensity, functional status, meaningful pain response rates, analgesic consumption, and patient satisfaction will be evaluated during follow-up.

The primary objective is to determine whether cervical erector spinae plane block provides comparable short-term pain relief to cervical medial branch block.

Study Overview

• Status: Not yet recruiting
• Conditions: Chronic Neck Pain; Cervical Facetogenic Pain; Cervical Facet Joint Syndrome
• Intervention / Treatment: Other: Ultrasound-guided cervical medial branch block; Other: Ultrasound-guided cervical erector spinae plane block

Detailed Description

Cervical facet joints are an important source of chronic axial neck pain. Diagnostic cervical medial branch block is commonly used to identify facet-mediated pain and may also provide short-term analgesic benefit. However, this procedure requires precise targeting of the cervical medial branches and may be technically demanding in some patients.

The cervical erector spinae plane block is an ultrasound-guided interfascial plane block that may provide analgesia through cranio-caudal spread of local anesthetic along the paraspinal fascial plane. Although it has been increasingly used for perioperative and chronic pain indications, its role in cervical facetogenic pain has not been clearly established.

This study will compare the short-term analgesic effectiveness of ultrasound-guided cervical medial branch block and ipsilateral cervical erector spinae plane block in patients with clinically suspected cervical facetogenic pain. Eligible patients will be randomized to receive one of the two ultrasound-guided interventions. Pain intensity, functional disability, meaningful pain response, analgesic use, patient satisfaction, and procedure-related adverse events will be assessed during follow-up.

The study is designed to determine whether cervical erector spinae plane block can provide clinically meaningful pain relief comparable to cervical medial branch block in this patient population.

• Study Type: Interventional
• Enrollment (Estimated): 130
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ülkü Sabuncu, Assoc Prof; Phone Number: 905337085212; Email: sabuncuulku@gmail.com

Study Locations

• Turkey (Türkiye)
  • Ankara
    • Ankara, Ankara, Turkey (Türkiye), 06680
      • Ankara Bilkent City Hospital
      • Contact: Ülkü Sabuncu, Assoc Prof; Phone Number: 905337085212; Email: sabuncuulku@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 18 and 80 years
• Chronic neck pain lasting at least 3 months
• Clinical findings suggestive of cervical facetogenic pain
• Numeric Rating Scale pain score ≥4
• Ability to provide informed consent

Exclusion Criteria:

• Cervical radiculopathy or myelopathy
• Major neurological deficit
• Infection at the injection site
• Coagulopathy or anticoagulant therapy contraindicating intervention
• Allergy to local anesthetics
• Pregnancy
• Previous cervical interventional pain procedure within the last 3 months
• Severe psychiatric disease

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cervical Medial Branch Block; Ultrasound-guided cervical medial branch block will be performed at the clinically suspected symptomatic cervical facet levels.	Other: Ultrasound-guided cervical medial branch block; Ultrasound-guided cervical medial branch block performed at clinically suspected symptomatic cervical facet levels using local anesthetic for diagnostic and analgesic purposes.
Experimental: Cervical Erector Spinae Plane Block; Ultrasound-guided ipsilateral cervical erector spinae plane block will be performed at the symptomatic cervical level. I	Other: Ultrasound-guided cervical erector spinae plane block; Ultrasound-guided ipsilateral cervical erector spinae plane block performed at the symptomatic cervical level using local anesthetic for analgesic purposes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Meaningful Pain Response	Proportion of patients achieving at least 50% reduction in Numeric Rating Scale (NRS) pain score during the early post-procedural period.	Time Frame: 1 hour after the procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
NRS24	Change in pain intensity measured using the 11-point Numeric Rating Scale (0=no pain, 10=worst imaginable pain).	at 24 Hours
NRS1	Change in pain intensity measured using the 11-point Numeric Rating Scale.( 0=no pain, 10=worst imaginable pain)	1 week after the procedure
NDI	Functional disability associated with neck pain assessed using the Neck Disability Index.0 = no disability 50 = complete disability Higher scores indicate greater neck-related functional disability (worse outcome).	Baseline and 1 week after the procedure
GPE	Patient-reported global improvement evaluated using a 7-point Global Perceived Effect scale. The GPE scale ranges from -5 to +5, where: -5 = vastly worse 0 = no change +5 = completely recovered	1 week after the procedure
Analgesic Consumption	Need for rescue analgesic medication after the procedure.	24 hours and 1 week after the procedure
Patient Satisfaction	Patient satisfaction regarding the procedure.	1 week after the procedure
Complications	Procedure-related adverse events and complications.	Perioperative/Periprocedural

Collaborators and Investigators

• Sponsor: Ankara City Hospital Bilkent

Publications and helpful links

General Publications

• Elsharkawy H, Ince I, Hamadnalla H, Drake RL, Tsui BCH. Cervical erector spinae plane block: a cadaver study. Reg Anesth Pain Med. 2020 Jul;45(7):552-556. doi: 10.1136/rapm-2019-101154. Epub 2020 Apr 21.

Study record dates

Study Major Dates

• Study Start (Estimated): May 31, 2026
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: April 28, 2026
• First Submitted That Met QC Criteria: May 12, 2026
• First Posted (Actual): May 19, 2026

Study Record Updates

• Last Update Posted (Actual): May 19, 2026
• Last Update Submitted That Met QC Criteria: May 12, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 123456 (Innovate UK)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No