Atlanto-Axial and Atlanto-Occipital Joints Injection in the Treatment of Headaches and Neck Pain
Cervicogenic headache is referred pain from cervical structures innervated by the upper three cervical spinal nerves. The lateral atlanto-axial joint, which is innervated by the C2 ventral ramus, is a fairly common cause of cervicogenic headache. It may account for 16 % of patients with occipital headache.1 In human volunteers, distending the lateral atlanto-axial joint with contrast agent produces occipital pain, and injection of local anaesthetic into the joint relieves the headache.
KeywordsLocal Anaesthetic Vertebral Artery Cervicogenic Headache Occipital Headache Intractable Case
- 2.Busch E, Wilson PR. Atlanto-occipital and atlanto-axial injections in the treatment of headache and neck pain. Reg Anesth. 1989;14 Suppl 2:45.Google Scholar
- 6.Narouze SN, Casanova J. The efficacy of lateral atlanto-axial intra-articular steroid injection in the management of cervicogenic headache (abstract). Anesthesiology. 2004;101:A1005.Google Scholar
- 8.Narouze SN, Gutenberg L. Radiofrequency denervation of the lateral atlantoaxial joint for the treatment of cervicogenic headache (abstract). Reg Anesth Pain Med. 2007;32:A-8.Google Scholar
- 10.Narouze S. Ultrasonography in pain medicine: future directions. Tech Reg Anesth Pain Manag. 2009;13(3):198–202.Google Scholar
- 11.Narouze S. Complications of head and neck procedures. Tech Reg Anesth Pain Manag. 2007;11:171–7.Google Scholar