Ultrasound Guidance for Interventional Pain Management of Cervical Pain Syndromes

Ultrasound guidance for peripheral nerve blocks is now well established in the field of Regional Anesthesia (USRA). 1 Recently, we started to see a growing in- terest in using ultrasound to guide different procedures in interventional pain management (USPM). 2-4

The difference between USRA and USPM is obvious. In USRA, we are com- paring ultrasound guidance to other “blind” nerve localization techniques e.g. nerve stimulation or surface landmarks. On the other hand, in USPM we are comparing ultrasound guidance to other “imaging” techniques e.g. fluoroscopy (or CT scan). So, to advocate the use of ultrasound (US) in interventional pain management, US had to offer more advantages than what the traditional fluo- roscopy can offer.

The advantages of ultrasonography over fluoroscopy/CT are; no radiation exposure to both the patient and health care providers, visualization of soft tissues (nerves, muscles, vessels, etc), and real-time visualization of needle tip advancement relevant to surrounding structures. As the major advantage of US is soft tissue visualization, ultrasonography is particularly relevant in the cervical area with the multitude of vessels and other vital soft tissue structures compacted in a small area. 

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