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Anatomical Analysis of Medial Branches of Dorsal Rami of Cervical Nerves for Radiofrequency Thermocoagulation

Authors
 Tae Dong Kweon  ;  Ji Young Kim  ;  Hye Yeon Lee  ;  Myung Hwa Kim  ;  Youn-Woo Lee 
Citation
 Regional Anesthesia and Pain Medicine, Vol.39(6) : 465-471, 2014 
Journal Title
 Regional Anesthesia and Pain Medicine 
ISSN
 1098-7339 
Issue Date
2014
Abstract
BACKGROUND AND OBJECTIVES: Cervical medial branch blocks are used to treat patients with chronic neck pain. The aim of this study was to clarify the anatomical aspects of the cervical medial branches to improve the accuracy and safety of radiofrequency denervation. METHODS: Twenty cervical specimens were harvested from 20 adult cadavers. The anatomical parameters of the C4-C7 cervical medial branches were measured. The 3-dimensional computed tomography reconstruction images of the bone were also analyzed. RESULTS: Based on cadaveric analysis, most of the cervical dorsal rami gave off 1 medial branch; however, the cervical dorsal rami gave off 2 medial branches in 27%, 15%, 2%, and 0% at the vertebral level C4, C5, C6, and C7, respectively. The diameters of the medial branches varied from 1.0 to 1.2 mm, and the average distance from the notch of inferior articular process to the medial branches was about 2 mm. Most of the bifurcation sites were located at the medial side of the posterior tubercle of the transverse process. On the analysis of 3-dimensional computed tomography reconstruction images, cervical medial branches (C4 to C6) passed through the upper 49% to 53% of a line between the tips of 2 consecutive superior articular processes (anterior line). Also, cervical medial branches passed through the upper 28% to 35% of a line between the midpoints of 2 consecutive facet joints (midline). CONCLUSIONS: The present anatomical study may help improve accuracy and safety during radiofrequency denervation of the cervical medial branches.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00115550-201411000-00005&LSLINK=80&D=ovft
DOI
10.1097/AAP.0000000000000175
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실) > 1. Journal Papers
Yonsei Authors
권태동(Kweon, Tae Dong) ORCID logo https://orcid.org/0000-0002-5451-1856
김명화(Kim, Myoung Hwa) ORCID logo https://orcid.org/0000-0003-4723-9425
김지영(Kim, Ji Young) ORCID logo https://orcid.org/0000-0001-5822-0338
이윤우(Lee, Youn Woo)
이혜연(Lee, Hye Yeon) ORCID logo https://orcid.org/0000-0001-6945-1967
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100363
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