Anatomical analysis of medial branches of dorsal rami of cervical nerves for radiofrequency thermocoagulation.

Abstract:

BACKGROUND AND OBJECTIVES:Cervical medial branch blocks are used to treat patients with chronic neck pain. The aim of this study was to clarify the anatomical aspects of the cervical medial branches to improve the accuracy and safety of radiofrequency denervation. METHODS:Twenty cervical specimens were harvested from 20 adult cadavers. The anatomical parameters of the C4-C7 cervical medial branches were measured. The 3-dimensional computed tomography reconstruction images of the bone were also analyzed. RESULTS:Based on cadaveric analysis, most of the cervical dorsal rami gave off 1 medial branch; however, the cervical dorsal rami gave off 2 medial branches in 27%, 15%, 2%, and 0% at the vertebral level C4, C5, C6, and C7, respectively. The diameters of the medial branches varied from 1.0 to 1.2 mm, and the average distance from the notch of inferior articular process to the medial branches was about 2 mm. Most of the bifurcation sites were located at the medial side of the posterior tubercle of the transverse process. On the analysis of 3-dimensional computed tomography reconstruction images, cervical medial branches (C4 to C6) passed through the upper 49% to 53% of a line between the tips of 2 consecutive superior articular processes (anterior line). Also, cervical medial branches passed through the upper 28% to 35% of a line between the midpoints of 2 consecutive facet joints (midline). CONCLUSIONS:The present anatomical study may help improve accuracy and safety during radiofrequency denervation of the cervical medial branches.

journal_name

Reg Anesth Pain Med

authors

Kweon TD,Kim JY,Lee HY,Kim MH,Lee YW

doi

10.1097/AAP.0000000000000175

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

465-71

issue

6

eissn

1098-7339

issn

1532-8651

journal_volume

39

pub_type

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