Role of Radio Frequency for Cervical Facet Pain: Indication and Results

Abstract

Neck pain is a very frequent and disabling condition affecting up to 20% of the worldwide population. Among possible sources of pain, cervical zygapophyseal joint dysfunction is hypothesized to result from trauma and/or degeneration of the cervical facet joints. Cervical facet pain is often characterized by axial neck pain, which may radiate sub-occipitally to the shoulders or midback and does not present the characteristics of a neuropathic radicular pain present in case of radicular pain. Steroid injection into the zygapophyseal joint may be performed but in cases of refractory patient to conservative management. Radiofrequency neurolysis may be performed at the supposed pain level and the level above. The needle insertion should be very carefully performed and accurate needle placement is the rule. CT helps with accuracy and once needles are inserted. When performed after the diagnosis of cervical facet joint pain, cervical radiofrequency neurotomy is able to reduce significantly the pain coming from chronic facet disease.