Cervical infiltration under scanner: procedure and risks

cervical infiltration

Le cervical spine can sometimes be the seat of pathologies causing pain that is very difficult to sustain, especially when they no longer respond to the various conventional treatments offered.

The last few years have seen the emergence of a number of medical techniques making it possible to offer effective and precise treatments in order to relieve these pains, which scan-guided cervical infiltration.

What is a cervical infiltration under scanner ? In what cases is it offered? What are the benefits, risks and cost of this procedure? We tell you everything.

To better understand this therapeutic approach, it is necessary to know the anatomy of the cervical spine.

Cervical Spine Anatomy

La cervical spine constitutes the upper part of the spine which unites the skull to the rest of the spine.

It is made up of seven vertebrae connected by intervertebral discs formed of two parts, the central one named " pulpy nucleus » and the other, peripheral, which surrounds the previous one, called « fibrous ring ».

The shape of the cervical vertebrae makes it possible to separate this part of the column into the upper cervical spine, made up of the first two vertebrae "C1 and C2" named respectively " atlas " and " axis », and lower cervical spine, formed by the vertebrae ranging from C3 to C7.

At the level of the lower cervical spine, there are holes between the vertebrae named foramina which allow the passage of cervical nerves destined for the upper limbs.

The cervical spine also presents a Spinal canal occupied by the upper part of the spinal cord, that we call " cervical spinal canal ».

Finally, the cervical spine presents a curvature called " cervical lordosis ».

 Pathologies of the cervical spine

Given the significant mobility of the cervical spine, the latter is often the site of multiple pathologies, in particular pathologies degenerative, inflammatory or infectious. It can also be the site of trauma or tumor lesions.

We can thus distinguish:

  • The cervical disc herniation and l'Osteoarthritis, causing cervico-brachial neuralgia;
  • Cervical rheumatoid arthritis;
  • La degenerative disc disease cervical spine
  • Mechanical neck pain;
  • Acute or chronic cervical sprain;
  • La spondylodiscitis infectious;
  • Fractures of the cervical vertebrae;
  • Primary or secondary cervical tumors (metastases).

Cervical spine x-ray: procedure and risks

Cervical infiltration under scanner

THEscan-guided cervical infiltration is the act of injecting a steroid anti-inflammatory drug (cortisone) under radiological control (scanner) at the level of the cervical spine in order to reduce or even eliminate the inflammatory reactions causing pain at this level.

Different locations can be the site of an infiltration at the level of the spine, this makes it possible to distinguish:

  • Inter-laminar epidural infiltrations: when the drug is injected into the epidural spaces.
  • Periradicular infiltrations: also called foraminals. In this case, the infiltration is done at the origin of the painful nerve root, that is to say through the foramina, this type of infiltration is strongly discouraged at the level of the cervical spine.
  • The facet infiltrations: The facet joints being the joints located on each side of the spine at the posterior region.

In which cases is cervical infiltration indicated?

Lcervical infiltration is proposed secondarily, in case of failure of conventional drug treatments associated with rest, or when cervical pain type cervico brachial neuralgia persist for more than seven weeks.

It can also be proposed as first intention, in the case hyperalgesic radiculalgia secondary to a herniated disc or to a cervical spondylosis.

Difference with infiltration without radiological guide (benefits)

Scan-guided infiltrations have various benefits. Indeed, imaging improves the precision of the infiltrations while reducing the pain felt during its realization.

Radiological guidance during infiltrations also allows more secure injections by ensuring that sensitive elements such as nerves or vessels are not damaged.

Procedure

Scan-guided cervical infiltration is a painless procedure, which is carried out within the framework ambulatory (without hospitalization) and which lasts on average 15 to 20 minutes.

During the examination, the patient is in the prone position on a scanner table, arms along the body.

At first, the location of the injection site is practiced thanks to the realization of a first scanner. This area is then rigorously disinfected to ensure total asepsis of the gesture.

Then, after performing a local anaesthetic, an iodinated contrast product is injected to ensure that the drug is well diffused. And finally, the injection of the latter is carried out using a very fine needle.

The full cooperation of the patient is requested during this intervention. Indeed, it is important to stand still and follow the doctor's instructions to ensure an effective and uncomplicated procedure.

Risks and contraindications (side effects)

As with any medical procedure, the realization of a cervical infiltration under scanner has contraindications. We will quote the infections pre-existing at the injection site, blood clotting disorders, a drug allergy (iodinated contrast product or corticosteroids) and finally the pregnancy.

Being an invasive procedure, scan-guided cervical infiltration can cause side effects, which are fortunately rare when the rules of performance are respected.

The main side effects identified are infections, bleeding and allergic reactions related to iodinated contrast products or cortisone.

Some patients may experience a vagal discomfort Without gravity.

Finally, exceptionally and in extremely rare cases, paralysis can occur.

Convalescence

After an infiltration, an increase in the degree of pain can be perceived by the patient.

For this, taking an analgesic and anti-inflammatory treatment is recommended during 48 hours following the gesture. The appearance of transient paresthesias can also occur in the 24 to 48 hours.

It is recommended to the patient a total rest during the 48 hours following the intervention.

Efforts and heavy loads are not recommended during the first week.

How long does it last ? (Effective time)

The analgesic effect of an infiltration begins to appear on average three to five days after the gesture.

The average effective duration of an infiltration isone to two months.

A limit of three infiltrations per year and per site is generally recommended.

What about the price?

The average cost of cervical infiltration under scanner is estimated at 160 Euros, including medical expenses and the price of the infiltration itself.

Alternative treatments

Cervical infiltration under scanner can sometimes prove impossible to perform, this is the case when the patient has one of the above-mentioned contraindications.

In such situations, the use of alternative treatments then becomes essential.

The first treatment considered is obviously the medical treatment classic. Indeed, in the absence of being able to inject cortisone-type corticosteroids directly where the pain is felt, it is possible to take them orally.

The association of sessions of physiotherapy to these oral treatments also makes it possible to obtain very good results in the majority of cases and to relieve pain effectively.

Finally, and as a last resort, the surgical treatment to sometimes prove to be necessary, in particular in the event of failure of response to any conventional treatment and in the absence of response to infiltration.

Conclusion

Cervical back pain is nowadays an increasingly frequent reason for consultation in medicine. Fortunately, there are now many treatment options available to provide relief to the patient.

It is nevertheless necessary to remember that a healthy lifestyle and the practice of a sports activity remain essential to the prevention of these pains.

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