AB260. SOH26AB_0036. Cervical facet joint and cervical erector spinae hydrodissection: a case report

Background: Neck pain is common. Joint and muscle sources of neck pain are common. Facet joint injections and cervical erector spinae injections are used to treat both joint and muscle sources of neck pain. Hydrodissection is a minimally invasive technique involving the injection of fluid to separate fascial layers and release entrapped nerves and tendons. Its use in cervical erector spinae hydrodissection has not been reported.

Case Description: We present the case of a 55-year-old male with refractory neck pain. Despite extensive conservative therapies, including medications and physical therapy, he continued to experience neck pain. The patient underwent ultrasound-guided cervical facet joint and cervical erector spinae hydrodissection as a targeted approach to address perineural inflammation and nerve entrapment. A low concentration (5%) dextrose solution (10 mL) was used to free the muscle from surrounding scar tissue and muscle adhesions. The procedure was performed in a theatre setting. Following the hydrodissection procedure, the patient experienced improvement in pain with sustained improvement at 2 months of follow-up. Functional outcomes, including range of motion and daily activities, improved substantially. No complications were reported.

Conclusions: This case supports the potential role of cervical erector spinae hydrodissection as a safe, minimally invasive treatment option in combination with cervical facet joint injection for neck pain. Hydrodissection offers an alternative to more invasive interventions and warrants further investigation in the management of neck pain.

Keywords: Facet joint; hydrodissection; neck myofascial; ultrasound; case report