Comparison between retrolaminar and medial branch block in cervical facet joint arthropathy: Randomized, controlled trial

AbstractBackground Cervical facet joints are considered one of the causes of chronic posterior neck pain by 54–67%. Cervical medial branch nerve blocks (CMBB) or neurolysis and intra-articular injections have been described for relieving the neck pain originate from facet joint. Methods Patients were randomly allocated into one of two groups: CMBB group where CMBB was performed at the affected dermatomal level and one level above using 0.5 mL dexamethasome (8mg/2ml) and 0.5 mL 1% lidocaine in each level, while in the cervical retrolaminar block (CRB) group, CRB was performed using 2 mL dexamethasone (4mg/1ml) and 3 mL 1% lidocaine for each affected dermatomal level. Numerical rating score (NRS) was carried out for all patients before the procedure, 2 weeks, 2 and 3 months after the procedure (where zero equals no pain and 10 equals the worst pain). Neck Disability Index (NDI) was done before the procedure and 2 weeks after the procedure. Any complication has been monitored as vascular injury, pneumothorax and epidural or spinal injection. Results NRS and NDI improved in both group with no statistically significant difference between them. The time of the procedure was shorter in CRB group, while the vascular injury was higher in CMBB group. Conclusions CRB is a good alternative to CMBB in the management of cervical facet joint pain with similar pain relief, better NDI, shorter time of procedure and no serious complications. Trial registration: registered in the clinical trials.gov (NCT05184881 ) at 11/01/2022