Facet Joint Injection, Cervical Spine

KEY FACTS

Terminology

• Anesthetic ± corticosteroid injection into cervical facet joint

  • Diagnostic study for pain referable to cervical facet joint

Preprocedure

• Indications

  • Chronic or acute on chronic cervical facet osteoarthritis

  • Posttraumatic osteoarthritis

• Preprocedure imaging

  • Correlate imaging abnormality with patient symptoms

  • Assess degree of bone overgrowth and best place to access joint

Procedure

• Supine, decubitus, or prone depending on level to be injected/anatomic relationships

• Craniocervical junction

  • Occiput/C1: Lateral approach with patient supine or decubitus

  • C1/C2: Posterior approach with patient prone

  • CT imaging is preferred by some interventionalists in upper cervical region

• Subaxial cervical spine (C3-C7): Generally lateral approach with patient supine or decubitus

Post Procedure

• Reproduction of pain with injection

  • Concordant or discordant pain

  • Pain intensity before, during, and after injection

TERMINOLOGY