J Korean Med Sci.  2005 Aug;20(4):659-662. 10.3346/jkms.2005.20.4.659.

Cervical Facet Joint Injections in the Neck and Shoulder Pain

• Kim KH
• Choi SH
• Kim TK
• Shin SW
• Kim CH
• Kim JI

• KMID: 1712750
• DOI: http://doi.org/10.3346/jkms.2005.20.4.659

Abstract

The effects from cervical facet joint injections in those patients who have been complaining cervical zygapophyseal joint pain were compared. The patients were diagnosed originally as myofascial pain syndrome (MPS), cervical herniated nucleus pulposus (HNP), and whiplash-associated disorders (WAD). Patients with the zygapophyseal joints pain of C5-6 and C6-7 were classified by their pain origin as MPS, HNP, and WAD. All patients had been undergone cervical zygapophyseal joints injections with the mixture of lidocaine and triamcinolone unilaterally or bilaterally through the posterior approach under C-arm imaging guide. The therapeutic effects were compared with reduction of numeric rating scale (NRS) of pain before and immediately after blockade and symptom-free periods in each group after 12 months. Symptom durations before injections were 16.1+/-9.6, 4.6+/-1.9 and 4.1+/-1.1 months in each MPS, HNP, and WAD groups. The reductions of NRS immediately after the blockade among the three groups were not different. However, the symptom-free duration after blockade lasted longer in the HNP group than the other two groups. In patients with cervical zygapophyseal pain syndromes, the analgesic effect from cervical facet joint blocks lasted longer in cervical HNP than MPS or WAD.

Keyword

Arthralgia; Cervical Vertebrae; Injections; Intraarticular; Zygapophyseal Joint

MeSH Terms

Adolescent
Adult
Aged
Anesthetics, Local/administration & dosage/therapeutic use
Anti-Inflammatory Agents/administration & dosage/therapeutic use
Comparative Study
Female
Humans
Injections
Lidocaine/administration & dosage/*therapeutic use
Male
Middle Aged
Neck Pain/*drug therapy
Research Support, Non-U.S. Gov't
Shoulder Pain/*drug therapy
Treatment Outcome
Triamcinolone/administration & dosage/*therapeutic use
Zygapophyseal Joint/drug effects/pathology

Figure

• 

  Fig. 1 Cervical facet intraarticular injections through the posterior approach. (A) Patients are lying down on the prone position with a pillow. From the distance of 1 and 2 inches caudally from the surface landmark of the spinous process of C7, 22-gauge, 10-cm long needles were placed for aiming to the left C5-6 and right C6-7 facet joint. The angle of the needle was dependent on the degree of flexion of the neck and traction of the shoulder. Under the C-arm fluoroscopic guide, contrast media were identified on the C5-6 facet joint through the lateral view (B) and on the left C5-6 and C6-7 facet joints through the anteroposterior view (C). The needle must be placed between inner and outer pedicular lines on the anteroposterior view to prevent spinal cord damage or nerve A root injury.

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