Ultrasound-Guided Cervical Intervertebral Disc Injection Without Fluoroscopy

Cervical disc degeneration commonly results in referred neck pain, which is traditionally diagnosed via fluoroscopy-guided provocative discography. Herein, we discuss three cases of neck and shoulder pain treated with cervical intradiscal injections administered under ultrasound (US) guidance. The most painful intervertebral disc was identified using the sonopalpation technique, which involved palpation while visualizing anatomical structures using US. Injectant spread within the intervertebral disc was validated using superb microvascular imaging rather than fluoroscopy. Symptoms significantly improved following blocks at the identified sites, suggesting that US can be used to guide cervical intradiscal injections even in the examination room.