Abstract

The causes of facet pain in the cervical region are; Degenerative disease, Postural abnormalities and Trauma. If medication or physical therapy does not sustain pain relief there may be an indication of cervical facet denervation. The indications for cervical facet denervation are; Duration (pain) > 3 months, no causal therapy, transient response to local anesthetic injection and no neurological deficit. The contraindications RF-lesions are central pain syndrome, use of anticoagulants, or abnormal response to test block. The procedure has to be performed under fluoroscopy. Recently for cervical region pulsed rf is more preferred due to less complications. The complications are; Local pain, dizziness, ataxia, sympathetic block, injury of the vertebral artery or ventral ramus, local anesthetic injection into the vertebral artery, convulsion, air injection into the vertebral artery, serious neurological sequele, excess amount of local anesthetic passing to the epidural and subarachnoid space and advancing the needle penetrating to the epidural, subdural and subarachnoid space. Techniques in cervical region should be performed by experts and not recommended for beginners.

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