What is the role of cervical facet blocks in pain management?

Updated: Jun 19, 2018
  • Author: Anthony H Wheeler, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Intra-articular cervical zygapophyseal joint blocks should be performed by a highly skilled interventionist experienced with the use of fluoroscopy for needle placement. They are usually performed as a diagnostic maneuver to prove that a specific facet-joint is in fact the source of pain. Intra-articular cervical facet blocks are primarily used for diagnostic maneuvers (eg, to prove that a specific facet joint is the source of pain). [19]

Facet pathology is commonly presumed to be salient when pursuing localization of a primarily axial neck pain source. Blind injection techniques are no longer considered the standard of care because of the accessibility of fluoroscopy. The C3-4 to C6-7 levels can be approached using either a posterior or lateral approach. Only the lateral approach is in feasible for the C7-T1 joint because of the obligatory steep slope approach. An oblique approach to the C2-3 zygapophyseal level is necessary because the joint tends to slope caudally and medially. [20]

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