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Abstract
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Background and Aims Cervical Facet Syndrome (CFS) is a frequent cause of neck pain. Invasive measures include radiofrequency and cryoablation, however, there is scarce literature about cryoablation in CFS situations. We present a case of a patient with CFS, who underwent cryoablation of the medial branches of the right posterior roots of C4-C7.
Methods A male patient, 71 years, with history of hypertension, reported neck pain for 4 years, more intense on the right side, although radiating to the left upper limb (peak 8). A TC scan revealed ‘reduction of the left conjugation channel, possible left C6 commitment’. On clinical exam, he had pain on palpation of the cervical spinal apophyses, all cervical spine arch movements were painful, and the spurling test was negative.
Results After a positive diagnostic blockade of the medial branches of the right C4-C7 posterior roots, the patient had a pain recurrence after 1 week (peak 5). For this reason, we opted for re-intervention, performing ultrasound-guided, with neurostimulation, cryoablation of the same nerves, uneventfully, pain 0 at the end of the procedure.
Cryoablation probe
The abocath is introduced in contact with the target nerve, which serves as an introducer for the cryoablation probe
The cryoablation probe is introduced until it contacts the target nerve
Conclusions Cryoablation consists of the application of cold temperatures causing nerve damage by freezing. It has advantages over radiofrequency, it allows regeneration of nerve fibers, not leading to formation of neuromas and it can be repeated several times. A previous positive diagnostic blockade and the use of ultrasound, with neurostimulation, guaranteed the site to be ‘cryoablated’ with precision and safety. This success story is promising and encouraging, but more studies are needed to confirm the effectiveness of the technique.