Atlantoaxial (C1-2) Facet Joint Injection
Procedure Description:
A C1-2 facet (atlantoaxial joint) injection involves the precise administration of a small amount of local anesthetic and, sometimes, corticosteroid medication to the facet joint between the first and second cervical vertebrae. This injection serves both diagnostic and therapeutic purposes. It helps confirm whether pain originates from the C1-2 facet joint and can provide temporary pain relief by reducing inflammation and numbing the area. Relief from this procedure typically lasts for a few hours to several weeks, depending on the individual and the use of corticosteroids. The procedure is generally safe, with a low risk of complications.
What it treats:
This injection targets neck pain that may arise from inflammation or arthritis in the C1-2 facet joint. Symptoms often include localized upper neck pain, stiffness, and discomfort aggravated by rotation head movement or poor posture. It may also help address referred pain in the head or upper shoulders caused by C1-2 facet joint issues.
How it is performed:
C1-2 facet injections are performed under fluoroscopic (X-ray) guidance to ensure accurate placement of the needle. The area is cleaned, and a small amount of local anesthetic is used to numb the skin before inserting the needle. The entire procedure typically takes less than 10 minutes, minimizing discomfort while maximizing precision.
Pre-procedure instructions:
Wear loose clothing without metal buttons or zippers to the procedure. Typically the procedure is performed without IV sedation, however, if sedation is utilized, make sure to not eat or drink for 12 hours prior to the procedure. Also, no driving is advised for 12 hours after the procedure, so a driver home is required. If IV sedation is administered, the driver must be a friend or family member. If no IV sedation, then can be a ride service such as Uber. Typically medications that prevent clotting (blood thinners) do need to be held for a C1-2 injection.
What to expect after the procedure:
After the injection, monitor your pain levels closely for the next 2-3 days and ongoing. Record any changes in pain using a pain diary provided by your healthcare team. If you experience significant, temporary relief, a repeat injection may be recommended to confirm the diagnosis. For long-term relief, follow-up treatments such as PRP (platelet rich plasma) may be recommended. Temporary soreness at the injection site is normal and should not be confused with the underlying neck pain being evaluated.