A new method for stimulation of cervical facet joint under ultrasonographic guidance

Ahn, Kang; Kim, Eun Jung; Kim, Jae Hun; Park, Soo Young; Lee, Sang Chul

Clinical Research

General Article

Anesthesia and Pain Medicine 2010;5(3):196-200.
Published online July 31, 2010.

A new method for stimulation of cervical facet joint under ultrasonographic guidance

Kang Ahn, Eun Jung Kim, Jae Hun Kim, Soo Young Park, Sang Chul Lee

¹Chronic Pain Management Center, Cha Biomedical Center, Kangnam Cha Hospital, College of Medicine CHA University, Seoul, Korea.
²Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea. sangclee@snu.ac.kr

Abstract

BACKGROUND
Cervical facet joint needling and stimulation is useful for the management of cervical facet arthropathy, but a direct needling of the joint may injure the capsule and cause post-needling pain.We developed a new approaching technique for cervical facet joint needling and stimulation.
METHODS
We retrospectively reviewed medical records of 24 patients with cervical facet arthropathy who underwent facet joint needling and stimulation through oblique posterior approach.Under ultrasonographic guidance, a specially designed dry needle (Ahn's needle) was inserted at midline of posterior neck and advanced obliquely to posterior and lateral side of facet joint.The procedure was completed when a marked reduction in resistance was felt at the tip of the needle.Follow-ups using the numeric rating pain scale (NRS) and the rate of self-rated improvement were conducted at three weeks and about three months after last treatment by telephone interview.
RESULTS
Among them, 23 patients were enrolled.The average of NRS decreased from 6.8 +/- 3.0 to 2.7 +/- 3.0 at 3 weeks and to 2.9 +/- 2.0 at 3 months after the last treatment (P < 0.05).The average rate of self-rated improvement was 63.7 +/- 7.2 and 61.6 +/- 3.0% at 3 weeks and 3 months after the last treatment respectively.
CONCLUSIONS
Our result suggested that this technique for dry needling around cervical facet joint under ultrasound guidance is one of the successful options to treat neck pain derived from facet joint.

Key Words: Cervical facet arthropathy, Dry needling, Ultrasonography