Cervical Intra-Articular Facet Injection: Computed Tomography

Abstract

Intra-articular facet joint injections commonly refer to the injection of a contrast media and local anesthetic solution, with or without corticosteroids, directly into the facet joint space. The purpose of this procedure is pain relief as well as to establish an etiological diagnosis for surgical interventions such as joint denervation or radiofrequency ablation. Medial branch block, or facet nerve block, refers to injection of local anesthetic and possible corticosteroids along the medial branch nerve supplying the facet joints. Cervical intra-articular and facet nerve block injections are often part of a work-up for general or focal neck pain, headaches, or cervical muscle spasms. There is limited evidence for short- and long-term pain relief with cervical intra-articular facet joint injections. Cervical medial branch nerve blocks with local anesthetics demonstrate moderate evidence for short- and long-term pain relief with repeat interventions, and strong evidence exists for long-term pain relief following cervical radiofrequency neurotomy.