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Ultrasound-Guided Cervical Zygapophyseal (Facet) Intra-Articular Injection

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Atlas of Ultrasound-Guided Procedures in Interventional Pain Management
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Abstract

Cervical facet joints are diarthrodial joints formed by the superior articular process of one cervical vertebra articulating with the inferior articular process of the vertebrae above at the level of the junction of the lamina and the pedicle. The angulation of the facet joint increases caudally, being about 45 degrees superior to the transverse plane at the upper cervical level to assuming a more vertical position at the upper thoracic level. The superior articular process also faces in a more posteromedial direction at the upper cervical level, and this changes to a more posterolateral position at the lower cervical level, with C6 being the most common transition level [1, 2].

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References

  1. Pal GP, Routal RV, Saggu SK. The orientation of the articular facets of the zygapophyseal joints at the cervical and upper thoracic region. J Anat. 2001;198:431–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Yoganandan N, Knowles SA, Maiman DJ, Pintar FA. Anatomic study of the morphology of human cervical facet joint. Spine. 2003;28:2317–23.

    Article  PubMed  Google Scholar 

  3. Inami S, Kaneoka K, Hayashi K, Ochiai N. Types of synovial fold in the cervical facet joint. J Orthop Sci. 2000;5:475–80.

    Article  CAS  PubMed  Google Scholar 

  4. Pearson AM, Ivancic PC, Ito S, Panjabi MM. Facet joint kinematics and injury mechanisms during simulated whiplash. Spine. 2004;29:390–7.

    Article  PubMed  Google Scholar 

  5. Kallakuri S, Singh A, Chen C, Cavanaugh JM. Demonstration of substance P, calcitonin gene-related peptide, and protein gene product 9.5 containing nerve fibers in human cervical facet joint capsules. Spine. 2004;29:1182–6.

    Article  PubMed  Google Scholar 

  6. Manchikanti L, Boswell MV, Singh V, Pampati V, Damron KS, Beyer CD. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions. BMC Musculoskelet Disord. 2004;5:15.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Barnsley L, Lord SM, Wallis BJ, Bogduk N. The prevalence of chronic cervical zygapophysial joint pain after whiplash. Spine. 1995;20:20–5.

    Article  CAS  PubMed  Google Scholar 

  8. Hove B, Gyldensted C. Cervical analgesic facet joint arthrography. Neuroradiology. 1990;32:456–9.

    Article  CAS  PubMed  Google Scholar 

  9. Barnsley L, Lord SM, Wallis BJ, Bogduk N. Lack of effect of intra-articular corticosteroids for chronic pain in the cervical zygapophysial joints. N Engl J Med. 1994;330:1047–50.

    Article  CAS  PubMed  Google Scholar 

  10. Carragee EJ, Hurwitz EL, Cheng I, Carroll LJ, Nordin M, Guzman J, Peloso P. Treatment of neck pain: injections and surgical interventions: results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders. Spine. 2008;33:S153–69.

    Article  PubMed  Google Scholar 

  11. Barnsley L, Medial BN. Branch blocks are specific for the diagnosis of cervical zygapophyseal joint pain. Reg Anesth. 1993;18:343–50.

    PubMed  CAS  Google Scholar 

  12. Galiano K, Obwegeser AA, Bodner G, Ploner F. Ultrasound-guided facet joint injections in the middle to lower cervical spine: a CT-controlled sonoanatomic study. Clin J Pain. 2006;22:538–43.

    Article  PubMed  Google Scholar 

  13. Galiano K, Obwegeser AA, Bale R, Harlander C, Schatzer R, Schocke M, et al. Ultrasound-guided and CT-navigation-assisted periradicular and facet joint injections in the lumbar and cervical spine: a new teaching tool to recognize the sonoanatomic pattern. Reg Anesth Pain Med. 2007;32:254–7.

    PubMed  Google Scholar 

  14. Obernauer J, Galiano K, Gruber H, Bale R, Obwegeser AA, Schatzer R, Loizides A. Ultrasound-guided versus computed tomography-controlled facet joint injections in the middle and lower cervical spine: a prospective randomized clinical trial. Med Ultrason. 2013;15:10–5.

    Article  PubMed  Google Scholar 

  15. Narouze SN, Provenzano DA. Sonographically guided cervical facet nerve and joint injections: why sonography? J Ultrasound Med. 2013;32:1885–96.

    Article  PubMed  Google Scholar 

  16. Narouze S, Peng P. Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy and procedures. Part II: axial structures. Reg Anesth Pain Med. 2010;35:386–96.

    Article  PubMed  Google Scholar 

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Narouze, S.N. (2018). Ultrasound-Guided Cervical Zygapophyseal (Facet) Intra-Articular Injection. In: Narouze, S. (eds) Atlas of Ultrasound-Guided Procedures in Interventional Pain Management. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-7754-3_7

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  • DOI: https://doi.org/10.1007/978-1-4939-7754-3_7

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