Ultrasound-guided high-thoracic paravertebral block relieves referred pain caused by cervical spondylosis and provides stellate ganglion–blocking effect

A 71-year-old man visited our outpatient unit for pain around the back of the lower neck and scapular arch originating from cervical spondylosis, with some trigger points on the left side related to zygapophyseal joint. We obtained written informed consent and performed an ultrasound (US)–guided high-thoracic paravertebral block at the T1 level, using an M-turbo (Fujifilm Sonosite, Inc, Bothell, WA) and a microconvex array transducer (5-8 MHz, C11x; Fujifilm Sonosite, Inc). After placing the patient in a lateral decubitus position (with the side to be blocked on top), we confirmed the C7 spinous process as the most prominent point on the midline of the lower neck.

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