Cryoneurolysis for the treatment of cervical facet joint syndrome: a technical note

OBJECTIVE: Neck pain has an annual prevalence of 30%. A frequent cause of neck pain is cervical facet joint pain. In cases of refractory cervical facet joint pain, radiofrequency can be employed, but the grade of evidence attested in systematic reviews is fair. Cryoneurolysis has been reported to induce favorable outcomes in lumbar facet joint pain. We sought to examine the feasibility of cervical facet joint cryoneurolysis. SETTING: Tertiary academic pain center. PATIENTS AND METHODS: We report here the operative technique of cervical facet joint cryoneurolysis for patients with cervical facet joint pain. The procedure is performed under CT-guidance. The lesion points are defined with the help of sensory stimulation. RESULTS: Six cervical facet joint denervations were carried out in five patients. All patients had an uneventful course with adequate pain relief. Apart from soreness of the paravertebral muscles no severe side effects were encountered. CONCLUSION: This is the first report of cryoneurolysis for the treatment of cervical facet joint pain. The technique is feasible and warrants further studies.