The Unsafe Way and the Safe Way to Inject the C1-C2 facet Joint

Are high upper cervical spine injections safe when performed under basic ultrasound, or do they carry hidden, life-threatening risks? In this video, Dr. Chris Centeno breaks down a high-stakes case involving the C0-C1 and C1-C2 facet joints to explain why proper imaging guidance is a non-negotiable requirement for patient safety. Dr. Centeno highlights the immense dangers of attempting these high-risk procedures using improper techniques or relying on under-qualified providers. He discusses a real case where an mid-level provider attempted a high cervical injection, exposing the patient to catastrophic complications such as accidental injection into the vertebral artery or the spinal canal—which can result in posterior circulation strokes or sudden respiratory failure. You will learn about the strict technical limitations of ultrasound in these deep anatomical zones, why a short-axis approach increases patient risk, and why the clinical long-axis alternative provides superior safety. Dr. Centeno advocates for the absolute necessity of C-arm fluoroscopy, contrast-confirmed arthrograms, and advanced Digital Subtraction Angiography (DSA) to clearly map out danger zones, maximize target visibility, and ensure precise needle placement. Dr. Chris Centeno practices at the Centeno-Schultz Clinic and is one of the pioneering founders of interventional orthobiologics. Backed by decades of clinical expertise and extensively published peer-reviewed research, he remains committed to educating both patients and medical professionals on the gold standards of care for complex cervical spine interventions. 🔔 If you find this content helpful, please like, comment, and subscribe to stay informed.    / @centenohome   To schedule a telemedicine or in-person visit, call +1-303-429-6448 or email us at icabral@centenoschultz.com. Dr. Centeno also answers questions on his Reddit thread at   / picl   Join him for weekly Facebook Lives at   / centenoschultzclinic   to learn more. Download Dr Centeno's book on craniocervical instability at https://centenoschultz.com/craniocerv... Join CCI Communities: PICL SubReddit: https://www.reddit.com/r/PICL/?rdt=58942 PICL Facebook Group:   / ccjpicl   Follow us for updates and news: Website: https://centenoschultz.com/ https://regenexx.com/ Facebook:   / centenoschultzclinic   Instagram:   / centenoschultzclinic   LinkedIn:   / chris-centeno-m-d-b6838024   Centeno-Schultz Clinic 403 Summit Blvd Suite 201 Broomfield, CO 80021 303-429-6448 Timestamps: 00:00 - Introduction and Topic Overview 02:01 - Observation of Improper Technique 05:19 - Potential Severe Complications 07:20 - Recommendations for Safer Practices 09:15 - Advanced Imaging Techniques 11:14 - Argument Against Mid-Level Providers Performing High-Risk Procedures 11:47 - Patient Education