Cervical facet pain

BACKGROUND: Axial neck pain is often associated with cervical instability, and surgical options are often reserved for patients with either neurological compromise or deformity of the spine. However, cervical facet arthropathy is often implicated with instability and the location of painful generators is often difficult to ascertain. Single-photon emission computed tomography (SPECT-CT) presents an adjunct to conventional imaging in the workup of patients with suspected facetogenic pain...

BACKGROUND: Zygapophysial joints (Z joints) can be a source of back pain and of neck pain, but the cause of pain is not known. Some authors attribute the pain to osteoarthritis but without citing evidence. OBJECTIVES: The present review was undertaken to determine if there was sufficient evidence of association between spinal pain and osteoarthritis of Z joints to justify osteoarthritis being held to be the cause of pain. The null hypothesis was that osteoarthritis of Z joints does not cause back pain or neck pain...

INTRODUCTION AND IMPORTANCE: To report the sequential treatment of a Type II odontoid fracture combined with a severe lower cervical (C6-7) fracture-dislocation featuring bilateral facet joint interlocking. CASE PRESENTATION: A 58-year-old male who had suffered an injury in a car accident, He presented neck pain and extremity paralysis. His neurological function was classified as per the American Spinal Injury Association (ASIA) impairment scale as Grade A, indicating complete deficits below the C6 spinal cord level...

BACKGROUND: Despite the routine use of radiofrequency (RF) for the treatment of chronic pain in the lumbosacral and cervical region, there remains uncertainty on the most appropriate patient selection criteria. This study aimed to develop appropriateness criteria for RF in relation to relevant patient characteristics, considering RF ablation (RFA) for the treatment of chronic axial pain and pulsed RF (PRF) for the treatment of chronic radicular pain. METHODS: The RAND/UCLA Appropriateness Method (RUAM) was used to explore the opinions of a multidisciplinary European panel on the appropriateness of RFA and PRF for a variety of clinical scenarios...

A 42-year-old man presented with neck pain after a fall from a tree. Spine computed tomography (CT) illustrated the right C5 superior articular process fracture without displacement. Magnetic resonance imaging (MRI) confirmed the fracture and injury of the posterior ligament complex. Initially he was managed conservatively with a neck brace as there were no signs of instability or vertebral body misalignment. However, three days after discharge, right shoulder weakness and numbness of the right upper arm became prominent...

BACKGROUND: Currently, in the specialized literature there are no substantiated clinical and radiological indications for differentiated use of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) in the treatment of patients with two-segmental cervical degenerative diseases. The objectives of this study were to (I) identify risk factors that were associated with unsatisfactory results of two-level ACDF and one-level ACCF in the treatment of patients with cervical degenerative diseases despite current perioperative management, and (II) develop a clinical and radiological algorithm for personalized surgical tactics...

BACKGROUND: Septic arthritis of the spinal facet joints is increasingly recognized in the era of magnetic resonance imaging, but its epidemiology, clinical features, management, and prognosis are ill-defined. METHODS: We review 101 previously published cases and report 16 cases occurring at our institutions between 2006 and 2018. RESULTS: Most patients presented with fever (60%) and back or neck pain (86%). Radiation into the hip, buttock, or limb was present in 34%...

BACKGROUND Neck pain is a prevalent and burdensome health issue, with autologous conditioned serum (ACS), like Orthokine, being a recognized treatment for musculoskeletal conditions due to its anti-inflammatory effects. However, the optimal ACS administration method for neck pain remains unclear. The existing literature lacks robust evidence, especially for different injection techniques. This study aimed to compare ACS infiltration into cervical fascia with periarticular administration to determine if the former is as effective in alleviating neck pain, offering a novel approach to its management...

BACKGROUND: Osteoblastomas, although rare, are benign primary bone tumors, with cervical spine involvement being exceptionally uncommon. Late diagnosis, especially in aggressive cases, can lead to surgical challenges. Oxidized regenerated cellulose (ORC) used for hemostasis may result in complications if left in the surgical field. CASE DESCRIPTION: An 8-year-old female presented with six months of intractable neck pain accompanied by swelling, hindering proximal right upper extremity evaluation...

BACKGROUND: The emergence of novel minimally invasive techniques has opened new horizons for the management of degenerative diseases of the spine. Platelet-rich plasma (PRP) has gained considerable attention through its applications in various pathologies. In the present review, an overview of the science behind the application of PRP is provided, ultimately focusing on the clinical trials that may render it a useful tool in the hands of spine surgeons in the future. METHODS: A review of the available literature is conducted, focusing on its existing clinical and experimental applications with a particular interest in the degenerative diseases of the spine...

BACKGROUND: Ultrasound (US) guidance is widely used for needle positioning for cervical medial branch blocks (CMBB) and radiofrequency ablation, however, limited research is available comparing different approaches. OBJECTIVE: We aimed to assess the accuracy and safety of 3 different US-guided approaches for CMBB. STUDY DESIGN: A cadaveric study divided into ultrasound-guided needle placement and fluoroscopy evaluation stages. SETTING: Department of Pathology, Forensic, and Insurance Medicine, Semmelweis University...

BACKGROUND: A cervical radiofrequency ablation is a procedure that can be performed to treat arthritis-related pain in the neck and upper back. There have been no large studies reporting complications after this procedure. We report a case of a 55-year-old woman with iatrogenic vertebral artery dissection of C3-C4 with segmental occlusion leading to a posterior fossa stroke and lateral medullary stroke after a high-grade cervical nerve ablation. CASE REPORT: A 55-year-old woman presented to the Emergency Department with vomiting, neck pain, temperature changes, dizziness, and dysarthria after undergoing C2-C3, C4-C5 nerve ablation 30 min prior to arrival...

Delayed presentation of lower cervical facet dislocations is uncommon, and there is no standardized way to approach these neglected injuries. The literature on neglected lower cervical facet dislocations is limited to case reports and few retrospective studies. This justifies the need for a comprehensive review of this condition. Our purpose was to elaborate a review on the epidemiology, clinical and radiological presentation, and treatment techniques and approach to these neglected injuries. Middle-aged adults from 30 to 50 represent 73...

OBJECTIVE: To compare the effects of muscle energy techniques, facet joint mobilisation and conventional physical therapy on pain, disability, cervical lordosis and range of motion in patients with chronic neck pain. METHODS: The parallel-design randomised controlled trial was conducted at the Physical Therapy and Rehabilitation Department of the Heavy Industries Taxila Hospital, Taxila Cantt, Pakistan, from December 2020 to May 2021, and comprised patients of either gender aged 35-50 years who had chronic neck pain, recurrent neck pain, and cervical spine curve...

INTRODUCTION: We developed a convolutional neural network (CNN) model to predict treatment outcomes of transforaminal epidural steroid injection (TFESI) for controlling cervical radicular pain due to cervical foraminal stenosis. METHODS: We retrospectively recruited 293 patients with cervical TFESI due to cervical radicular pain caused by cervical foraminal stenosis. We obtained a single oblique cervical radiograph from each patient. We cut each oblique cervical radiograph image into a square shape, including the foramen that was targeted for TFESI, the intervertebral disc, the facet joint of the corresponding level with the targeted foramen, and the pedicles of the vertebral bodies just above and below the targeted foramen...

PURPOSE OF REVIEW: Persistent spinal pain syndromes are pervasive and lead to functional impairment, increased healthcare utilization, potential disability, and high societal costs. Spinal (cervical, thoracic, lumbar, and sacroiliac joint) pain includes mechanical, degenerative, inflammatory, oncologic, and infectious etiologies. Regenerative medicine is a novel biotechnology targeting mechanical, degenerative, and inflammatory conditions believed to cause pain. Preparations including platelet-rich plasma, mesenchymal stem cells (adipose tissue and bone marrow aspirate concentrates), and growth factors are derived from an autologous donor...

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness)...

Radiofrequency (RF) is a minimally invasive procedure for interrupting or modifying nociceptive pathways to manage musculoskeletal neuropathic and nociplastic pain. RF has been used to manage cervical and lumbar facet joint syndromes. The benefits of RF are the following: it is safer than surgery; it doesn´t need general anesthesia, by that means diminishing the complications; it causes pain alleviation for a minimum of 3-4 months; it can be repeated if needed; it improves joint function; and it minimizes the necessity for oral pain treatment...

STUDY DESIGN: Observational Study BACKGROUND: Symptomatic pseudarthrosis is one long-term complication in patients treated with anterior discectomy and fusion (ACDF). When revising a pseudarthrosis, a surgeon must decide to intervene posteriorly and/or anteriorly. Open posterior cervical fusion (PCF) is attractive for high rates of arthrodesis, however this technique introduces risks of added complications resulting from extensive soft tissue dissection. The purpose of this study was to assess long-term outcomes in patients undergoing tissue-sparing PCF with facet instrumentation to treat a single level pseudarthrosis...

BACKGROUND: Cervical facet joint disease is a common source of neck pain and its prevalence increases with aging. Conservative multimodal management options (e.g., strengthening of neck muscles, non-steroidal anti-inflammatory medications, massage, and thermal modalities) often fail to relieve pain. Cervical medial branch nerve (CMBN) radiofrequency neurotomy (RFN) is an effective minimally invasive technique for treating chronic neck pain secondary to facet joint disease. An end-on approach for this procedure has been proposed that may be technically easier and require less time while reducing post-procedural discomfort...