Abstract
Cervical pain is a common symptom among the general population. When conservative strategies fail to provide pain relief, cervical spine injections may be considered. Compared with cervical surgery, cervical injections have low major complications and, with the right indication, have demonstrated good results.Traditionally, these types of procedures have been performed under fluoroscopy; however, in recent years, ultrasound has become a more common imaging modality to guide spinal injections.Although ultrasound presents an excellent quality image for soft tissue and allows the observation of vascular tissues, nerves, and the contour of bone surfaces, the cervical region has a complicated neurovascular network and a comprehensive understanding of the cervical sonoanatomy should remain as the basis before one can plan cervical ultrasound-guided intervention.This paper aims to show the advantages of ultrasound in facilitating the performance of cervical spine procedures, including facet joint injections, medial branch blocks, and selective nerve root blocks; analyze the sonoanatomy and landmarks of commonly intervened cervical structures; and illustrate how these procedures can be performed safely and precisely under ultrasound guidance.
Highlights
BackgroundCervical spine disorders and cervical pain affect approximately 40% of the population at some time of their lives, increasing its prevalence with advancing age
This paper aims to show the advantages of ultrasound in facilitating the performance of cervical spine procedures, including facet joint injections, medial branch blocks, and selective nerve root blocks; analyze the sonoanatomy and landmarks of commonly intervened cervical structures; and illustrate how these procedures can be performed safely and precisely under ultrasound guidance
Cervical spine injections have been performed under anatomic references or more often with fluoroscopy or computed tomography (CT) guidance
Summary
Cervical spine disorders and cervical pain affect approximately 40% of the population at some time of their lives, increasing its prevalence with advancing age. About 5%-20% of these patients maintain symptoms for more than six months after the onset of pain, characterized by frequent exacerbations with worsening of the pain. When conservative strategies like analgesics or physiotherapy fail to provide pain relief, cervical spine interventions may be considered. Cervical spine injections have been performed under anatomic references or more often with fluoroscopy or computed tomography (CT) guidance. In recent years, there has been a big rise in the use of ultrasound (US) in pain medicine, including with cervical pathology, as evidenced by the remarkable increase in the scientific literature about US-guided injections in the management of chronic neck pain [2]
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