BACKGROUND: Adhesive C6 radiculopathy, a notable type of cervical radiculopathy, is the development of adhesive scar tissue or fibrosis surrounding nerve roots. This case report details the role of image-guided modalities in alleviating symptoms in a patient with adhesive cervical radiculopathy.

CASE REPORT: A 43-year-old female patient presented with a several-month history of right neck pain radiating specifically to the posterior shoulder, radial forearm, thumbs, and index area. Physical Sign: 1. negative Spurling’s sign, 2. no muscle wasting, 3. pain felt on right neck based upon left-side Spurling’s maneuver, suggesting tight right scalene muscle, 4. weak right wrist resisted extension manual muscle testing (MMT) (4+/5), compared to left counterpart (MMT 5/5). Ultrasonography over right neck revealed an engorged/enlarged C6 root near trunk level, which uniquely observed a margin between the root and peripheral connective was blurred on its superficial junction.

CONCLUSIONS: This case report reveals the efficacy of ultrasound-guided intraperineurial, extraradicular hydrorelease in treating patients with adhesive cervical radiculopathy.

KEYWORDS: Ultrasound-guided hydro prelease, adhesive C6 radiculopathy, intra-perineurial, minimally invasive procedure