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. 2017 Sep 18:10:2263-2269.
doi: 10.2147/JPR.S144255. eCollection 2017.

Outcomes of C1-2 joint injections

Christopher M Aiudi  1 , W Michael Hooten  2 , Rebecca A Sanders  2 , James C Watson  2 , Susan M Moeschler  2 , Halena M Gazelka  2 , Bryan C Hoelzer  2 , Jason S Eldrige  2 , Wenchun Qu  3 , Tim J Lamer  2
Affiliations

Outcomes of C1-2 joint injections

Christopher M Aiudi et al. J Pain Res. .

Abstract

Objective: Intra-articular injections of the C1-2 joint are an effective therapeutic option for pain generated from degenerative and inflammatory conditions affecting the joint. Limited information exists about the adverse events (AEs) associated with these injections. The primary aim of this study is to describe the frequency and type of AEs associated with C1-2 joint injections. The secondary aim is to identify clinical factors associated with the occurrence of AEs of C1-2 joint injections.

Design/methods: A retrospective chart review was conducted on all C1-2 joint injections performed at the Mayo Pain Medicine Clinic in Rochester, MN, from January 1, 2005 through July 31, 2015. AE data were extracted from procedural and post-procedural clinical notes. Analysis was conducted to determine correlations between any AE and demographic and clinical characteristics. Using univariate and multivariate logistic regression analyses, associations were determined.

Results: From January 1, 2005 to July 31, 2015, 135 C1-2 injections were performed on 72 patients. Overall, at least 1 AE was reported in 18.5% of the injections. The most common AEs were post-procedural increase in pain and procedural vascular contrast uptake. There was a significant association between AE occurrence and greater pre-procedural maximum pain score.

Conclusions: AEs from C1-2 joint injections occurred commonly, but there were no persistent or serious AEs associated with these injections. The data also demonstrate that patients with higher pre-procedural maximum pain scores are more likely to experience an AE.

Keywords: C1–2 joint; adverse event; facet; injection.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Anatomy of the C1–2 joint. Notes: Lateral (A) and posterior (B) illustration of the approximate needle trajectory for a C1–2 joint injection demonstrating the relationship of the vertebral artery and the C2 nerve root and dorsal root ganglion. Landmarks within the images include: a, mastoid process. b, vertebral artery; c, C2 dorsal root ganglion; d, anterior C1–2 joint; e, needle entering posterior C1–2 joint.
Figure 2
Figure 2
Needle position and contrast filling of the C1–2 joint. Notes: (A): AP needle position in the lateral C1–2 joint (arrow). (B): C1–2 joint arthrogram with contrast filling the joint (arrow). (C): Lateral view of needle position in the posterior C1–2 joint (needle tip is at the posterior joint margin and arrow tip is at the anterior joint margin).
See this image and copyright information in PMC

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