frequent procedures
 

ATLANTOOCIPITAL AND ATLANTOAXIAL JOINT INJECTIONS
(AO AND AA INJECTIONS)
Atlantoocipital and atlantoaxial joint injections are a modified injection into the upper cervical facet joint. These facet joints are not typical facet joints seen in the cervical spine region, and morphologically are different because of the difference in the function that they perform. The injection is done because of chronic headache that is cervicogenic in origin, and suboccipital area pain and tenderness that is associated with occipital headaches, and head pain. This procedure is performed under fluoroscopic guidance with the patient in the prone position, and frequently access can only be achieved with open mount view, and adjustment and tilting of the fluoroscopy machine or unit to achieve maximal visibility and visual access of the odontoid process, the AA joint and AO joint. The procedure is usually quick and effective, and should be done only by experienced physicians because of the risk of this procedure.

 

 

CONTRAINDICATIONS: Patients on anticoagulation including Heparin and Coumadin should not undergo this procedure until appropriate time interval has passed. Patients allergic to contrast material should also not undergo this procedure, since contrast material is needed to define the capsule enclosed in the joint where the medication will be placed. Patients who are pregnant or suspect that they may be pregnant should also not undergo this procedure.

COMPLICATIONS: AO and AA joint injection is a procedure that may result in intravascular injection and seizure, may also result in intracranial injection with significant impairment of vital functions at the brainstem, and may require supports of ventilation in these patients if that were to occur. During the procedure, a test dose is always recommended in less than 0.5 cc of injection of local anesthetic before the actual medication is instilled into the joints. The needle is placed into the appropriate location on guidance, and usually patients achieve near dramatic improvement with one or three injections, including AA and AO joints, when these are the source of their chronic pain.

SEDATIVES: Sedatives are not usually indicated and the patient should be completely alert during this procedure and cooperative. Lack of full patient cooperation is also a contraindication of this procedure.

 

<< Back To Procedure List