Item request has been placed!
×
Item request cannot be made.
×
Processing Request
Lateral atlanto-axial joint access using the C2 pedicle.
Item request has been placed!
×
Item request cannot be made.
×
Processing Request
- Additional Information
- Abstract:
Background Neck pain and headaches can arise from the lateral atlanto-axial (LAA) joint. This pain can be diagnosed with intra-articular injections of local anesthetic. A widely used technique for access to the lateral atlanto-axial joint uses a posterior approach, but this approach can be hazardous because of the proximity of the vertebral artery, the dural sac, and the C2 spinal nerve and dorsal root ganglion. Objective The objective was to describe and test a new technique for accessing the LAA joint that avoids structures that lie behind the joint. Interventions The new technique was described and tested for tolerance in 10 patients with unilateral suboccipital pain and tenderness over the LAA joint, along with evidence of LAA joint arthropathy on SPECT CT. The technique requires inserting a needle along a trajectory tangential to the dorsal surface of the C2 lamina. It involves obtaining a declined view of the C2 lamina and C2 pedicle. Conclusions In all cases, the C2 pedicle was easily identified and allowed the needle to pass asymptomatically underneath the neurovascular structures behind the joint. The tactile response of the lamina of C2 provided important feedback regarding needle depth caudal to the LAA joint. [ABSTRACT FROM AUTHOR]
- Abstract:
Copyright of Pain Medicine is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
No Comments.