Infiltration of the Craniovertebral Region

The objective of this article is to explain the technique of C1-C2 arthrography as a suitable treatment for pain due to C1-C2 abnormalities. The technique is consistent with the puncture of the posterior aspect of the C1-C2 joint under fluoroscopic control. Arthrography is performed with 1 mL of contrast media. After that, 1 mL of long-acting steroid is injected. The articular cavity has an anterior recess and a posterior recess. The posterior recess is large and easily punctured. In 5% of cases, the ipsilateral joint is also opacified. This injection is indicated in cases of upper cervical pain because of C1-C2 osteoarthritis, inflammatory arthritis of the upper spine (rheumatoid disease, spondylarthritis), and cervico-occipital neuralgia (Arnold’s neuralgia) of the same causes or of unknown local origin. C1-C2 arthrography appears to be an efficient and safe technique for the treatment of upper cervical pain due to C1-C2 abnormalities