Ultrasound-guided cervical facet intra-articular injection

The prevalence of facet joint involvement in chronic neck pain has been reported to be from 35% to 55%, making it an important target of interventional pain therapy. The facet joint and capsule also have been shown to contain nociceptive elements, suggesting that it may be an independent pain generator. Although cervical medial branch block is easier to perform and is the appropriate diagnostic test to predict the response to radiofrequency neurotomy, cervical facet intra-articular injection has also been implemented in the diagnosis and treatment of facet joint-mediated pain. The use of ultrasound (US) imaging to facilitate nerve blocks has increased recently. US allows visualization of bony surfaces as well as soft tissues. Unlike fluoroscopy and computed tomography, US does not expose the patients or personnel to radiation, and the image can be performed continuously while the injectate can be visualized in real-time, thereby increasing the precision of injection. US imaging can be used to obtain well-defined images of the cervical facet column with real-time visualization of the spinal nerves and vessels and may improve the safety of the technique.