Position the patient in a prone position facing the operating bed with a small pillow under the forehead to allow air circulation between the patient’s mouth and nose and the table. The C-arm is rotated at an angle of 25 to 35 degrees caudal to the axial plane, without the slightest tilt from side to side. The rays pass through the articular eminence joint at this angle to obtain the best visual angle. Although the lateral approach with the patient in the lateral recumbent position can also be chosen for puncture of the cervical articulation, the operation of the needle approach under posterior-anterior radiographic guidance ensures that the operator can always see the position of the spinal canal, thus avoiding inadvertent spinal cord injury during medial approach. Blocking technique 2 mL of 1% lidocaine is first injected into the skin and subcutaneous tissue over the synovial joint to be blocked. The T1 segment is easily identified because its transverse process is connected to the first rib, and the individual cervical segments can be identified by counting upward from T1. A 22G, 3.5-inch spinal needle is inserted through the skin and continued until the needle is fixed in the soft tissue, making sure to keep the needle in the same axis as the x-ray path. The needle is then continued toward the joint space and the scan is repeated every 2 to 4 mm to ensure that the needle is in the same plane as the x-ray. Once the joint space is reached, the joint is imaged from the lateral side and the puncture needle is then gently inserted into the joint capsule. It is important that the needle tip does not enter the joint between the synovial joints, as this can easily damage the joint surface and worsen the pain with infiltration of local anesthetic medication if the medication is mistakenly injected here. Although the position of the needle tip in the joint can be confirmed by radiographic contrast, radiographic contrast can be omitted if the needle is positioned in the anterior-posterior and lateral planes. The volume of the synovial joint is very limited (usually <1 mL), so the amount of local anesthetic and steroid injected into the synovial joint is limited. Once the needle tip position is determined, steroids and local anesthetics are injected. Inject 80 mg of methylprednisone acetate or other equivalent into the joint, but injecting more than 40 mg into each joint is not necessary. Application of concentrated steroids (40mg/L or 80mg/mL) with a 1:1 ratio of local anesthetic (0.5% bupivacaine) provides rapid pain relief.