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Purpose: Currently, minimally invasive intervention surgery for cervical spondylotic radiculopathy mostly involves the use of cervical dorsal root ganglion (DRG) block or radiofrequency modulation therapy. Here, we proposed a novel transverse ultrasound-guided approach for puncturing the cervical dorsal root ganglion at the level of joint column for radiofrequency treatment. Patients and Methods: A retrospective analysis of the clinical data of 30 patients with cervical spondylotic radiculopathy admitted to the Pain Department of Taihe Hospital Affiliated with Hubei Medical University from January 2021 to March 2024 was performed. During surgery, motor electrical stimulation was used to induce movement in the nerve-innervated area, and the relationship between the puncture needle tip and the cervical DRG position was verified using a C-arm X-ray machine. The numerical rating scale (NRS) was used for preoperative and postoperative pain assessment, clinical treatment effectiveness was evaluated, surgical duration and the associated complications were also recorded. Results: Thirty patients exhibited clear cervical DRG images under ultrasound guidance, and the punctures were successful in all patients. Motor electrical stimulation induced movement in the corresponding nerve innervation area in the range of 0.3– 0.8 mv in all patients. No serious complications occurred during the procedure. Conclusion: The transverse ultrasound-guided approach for puncturing the cervical dorsal root ganglion at the level of joint column for radiofrequency treatment is effective, convenient, and safe. [ABSTRACT FROM AUTHOR]

Background: The management of thyroid nodules diagnosed as Bethesda III by fine-needle aspiration presents certain challenges, and there is an urgent need for a non-invasive and accurate method for early identification of the benign or malignant nature of Bethesda III nodules. Our objective is to develop and validate a clinical-radiomics nomogram based on preoperative ultrasound (US) images and clinical features, for predicting the malignancy of thyroid nodules with indeterminate cytology (Bethesda III)., Methods: Between June 2017 and June 2022, we conducted a retrospective study on 274 patients with surgically confirmed indeterminate cytology (Bethesda III) across two separate medical centers in Shanghai. The training and internal validation sets were comprised of 136 and 58 patients, respectively, all sourced from Shanghai's Sixth People's Hospital. To facilitate external test, a further 80 patients were selected from Tinglin Hospital. Utilizing preoperative US data, we obtained imaging markers for radiomic features. After feature selection, we developed a comprehensive diagnostic model to evaluate the predictive value for Bethesda III benign and malignant cases. The model's diagnostic accuracy, calibration, and clinical applicability were systematically assessed., Results: The results showed that the prediction model, which integrated US radiomics, and clinical risk features, exhibited superior stability in distinguishing between benign and malignant indeterminate thyroid nodules (Bethesda III). In the external test set, the area under the curve (AUC) was 0.824 [95% confidence interval (CI): 0.718-0.929], and the accuracy, sensitivity, specificity, precision, and recall were 0.775, 0.731, 0.796, 0.633, and 0.731, respectively., Conclusions: An integrated model, utilizing US radiomics and clinical risk features, effectively discriminates between benign and malignant indeterminate thyroid nodules (Bethesda III), thereby minimizing the need for unnecessary diagnostic surgeries and subsequent complications., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-24-310/coif). The authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)