RT Journal Article
SR Electronic
T1 Anatomical Analysis of Medial Branches of Dorsal Rami of Cervical Nerves for Radiofrequency Thermocoagulation
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 465
OP 471
DO 10.1097/AAP.0000000000000175
VO 39
IS 6
A1 Kweon, Tae Dong
A1 Kim, Ji Young
A1 Lee, Hye Yeon
A1 Kim, Myung Hwa
A1 Lee, Youn-Woo
YR 2014
UL http://rapm.bmj.com/content/39/6/465.abstract
AB 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.