Diagnostic and Interventional Ultrasound for Head and Neck Pain

Abstract

In this recent 10 years, anesthesiologists have been enthusiastic about using ultrasound (US) guidance to localize nerves in the field of regional anesthesia (USRA), because it affords real-time visualization of needle, nerve, and surrounding vasculature. Improvements in transducer technology and imaging processing within the recent years have increased interest in US-guided procedures, including not only regional anesthesia but also interventional pain management (USPM). Multiple radiologic modalities, including MRI, CT, fluoroscopy and Sonography have been used to guide needle placement for interventional pain management. However, these modalities may be limited alone by their individualized weaknesses. Pain that occurs in the neck and back of the head is a common set of symptoms. The cervical spine is a complex structure made up of seven cervical vertebrae, disc, facet joints (FJ), ligaments, muscles and sensitive nerves. Since the muscles of the cervical spine attach to the skull, problems in the neck can cause headaches in the back of the head. Here we concentrate on the US-guided interventions for head and neck pain originated from the cervical spine. The detail the procedures include: cervical medial branch block, facet joint, selective nerve root, third occipital nerve and great occipital nerve. Moreover, this presentation will contrast the pros and cons between the guidance of fluoroscopy and sonography. The multiple modalities guidance such as the combination of ultrasound and fluoroscopic guidance might be the faultless imaging guided tools for the head and neck interventional pain management.