C0-C1 joint injection: Anatomical, clinical and technical review

Interventional Pain Medicine Pub Date : 2024-10-23 DOI:10.1016/j.inpm.2024.100443

Christopher Mares , Carl Majdalani

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引用次数: 0

Abstract

Background

Cervicogenic headaches (CGH) are proven clinical entities. The prevalence of CGH arising from the atlanto-occipital (AO) joint is unknown. The best evidence for treatment of CGH is for third occipital nerve radiofrequency neurotomy. Treatment of CGH includes intra-articular injections into upper cervical spine joints.

Objective

To perform a review of the anatomy and clinical presentation of AO joint (AOJ) pain referral as well as a technical description to safely access the AOJ.

Methods

A literature review was performed to explore the intricacies of the cranio-cervical junction (CCJ) with a focus on the relation between the AOJ and vascular anatomy. Our technical approach is described with complementary images.

Results

The AOJ lies anterior to a venous sinus and slightly superior to the horizontally oriented vertebral artery crossing the joint line.

Conclusion

The authors propose a modified superior needle trajectory that seeks to avoid these vascular structures and to access the AOJ safely.

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C0-C1 关节腔注射：解剖、临床和技术回顾

背景颈源性头痛（CGH）是已被证实的临床症状。由寰枕关节引起的颈源性头痛发病率尚不清楚。治疗颈源性头痛的最佳方法是第三枕神经射频神经切断术。方法进行文献综述，探索颅颈交界处（CCJ）的复杂性，重点关注 AOJ 与血管解剖之间的关系。结果AOJ位于静脉窦的前方，略高于水平方向穿过关节线的椎动脉。结论作者提出了一种改良的上方进针轨迹，旨在避开这些血管结构，安全地进入AOJ。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Pain Medicine

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