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Ultrasound-guided cervical cervicis plane (CCeP) block: a cadaver study.

Prangmalee Leurcharusmee¹, Siriwat Thunyacharoen^2,3, Chirapat Inchai^2,3

¹Anesthesiology, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand.

Regional Anesthesia and Pain Medicine

|August 11, 2025

Summary

Ultrasound-guided cervical cervicis plane (CCeP) block effectively targets cervical dorsal rami for pain relief in spine surgery. This study confirms its selective spread and safety, avoiding adjacent structures.

Keywords:

Acute Pain Anesthesia, Regional Nerve Block Orthopedic Surgery

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Published on: January 31, 2025

Area of Science:

Anesthesiology
Anatomy
Pain Management

Background:

Cervical cervicis plane (CCeP) block is used for posterior cervical spine surgery analgesia.
Anatomical details and local anesthetic spread in the CCeP layer require further investigation.
Cadaveric study to evaluate CCeP block's anatomical characteristics and spread patterns.

Purpose of the Study:

Evaluate the spread of local anesthetic within the CCeP layer at C2 and C5 levels.
Assess the staining of targeted cervical dorsal rami.
Identify potential spread to adjacent anatomical structures.

Main Methods:

Utilized 20 fresh frozen cadavers for CCeP block.
Performed injections at C2 and C5 levels using 0.1% Methylene Blue dye.
Dissected cadavers to analyze dye spread within the CCeP layer.

Main Results:

C2 injections consistently stained C2 and C3 dorsal rami.
C5 injections consistently stained C3 to C5 dorsal rami, without affecting levels above C2.
No dye spread observed in the multifidus muscle, retrolaminar region, or ventral rami.

Conclusions:

CCeP block enables selective blockade of cervical dorsal rami at various levels.
The observed lack of spread to surrounding structures suggests a low risk of associated side effects.
This technique shows promise for targeted postoperative analgesia in cervical spine procedures.