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Technical Modification of Cervical Facet Joint Radiofrequency Ablation: A Novel Approach
Boqing Chen1, Daniel H Cho2, Kevin W Tang2
1Center for Advanced Pain Management and Rehabilitation, Metuchen, NJ.
Pain Physician
|April 1, 2025
Summary
This study introduces an oblique fluoroscopic view for cervical radiofrequency ablation (RFA), improving needle placement accuracy. This technique enhances visualization for treating cervical facet joint pain, overcoming anatomical challenges.
Area of Science:
- Interventional Pain Management
- Spinal Procedures
- Fluoroscopic Guidance
Background:
- Conventional cervical radiofrequency ablation (RFA) uses AP and lateral fluoroscopic views.
- Lateral views in the lower cervical spine are often obscured by patient anatomy, hindering accurate RFA needle placement.
Purpose of the Study:
- To introduce and standardize an oblique fluoroscopic view for cervical medial branch block (MBB) and RFA.
- To improve the accuracy and safety of RFA needle electrode placement in the cervical facet joint.
Main Methods:
- A novel technique using a 50-degree ipsilateral oblique fluoroscopic view was developed in a cadaveric model.
- The technique was subsequently tested in actual patient procedures for cervical facet joint RFA.
Main Results:
- Successful development of a technique for clear visualization of the RFA needle electrode at the articular pillar.
- The oblique view effectively overcomes patient-specific anatomical limitations, such as short necks and prominent shoulder musculature.
Conclusions:
- The oblique fluoroscopic view enhances visualization, increasing accuracy and potentially safety for cervical facet joint RFA.
- A potential drawback is the increased radiation exposure associated with the additional oblique view.
