Abstract
We report two patients with traumatic cervical syndrome who were treated with fluoroscopy-guided cervical facet block and rhizotomy. Case 1: A 32-year-old woman had a rear collision car accident when she was driving a car. Oral non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy did not improve the pain in the right posterior cervical region and face. The patient visited our clinic 1 year after the accident. Cervical facet blocks at C3/4 and C4/5 three times and cervical facet rhizotomy at C4 were performed under fluoroscopy. The pain in the posterior neck improved; however, pain in the face persisted. Stellate ganglion block (SGB) on the right was performed 10 times, which improved the facial pain. Case 2: A car hit a 61-year-old woman from behind when she was riding a bicycle. Pain in the right cervical region and tinnitus occurred thereafter. Oral NSAIDs and physical therapy did not improve the pain. The patient was referred to our clinic 6 months after the accident. Cervical facet blocks at C3/4 and C4/5 three times followed by SGB five times improved the pain and tinnitus. We conclude that repeated cervical facet blocks are effective for posterior cervical pain and that persistent pain despite repeated cervical facet blocks can be relieved by cervical rhizotomy in some patients with traumatic cervical symptoms.
