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Spinal facet injections:
The spinal facet joints are the “hinge” joints or “motion segments” of the cervical, thoracic, and lumbar spine. They provide the means by which complex spinal movements can occur, such as turning, bending, or twisting of the neck, trunk, and back. Disease, injury, or wear and tear can cause degeneration or deterioration of these joints with pain and restricted movement as a result. Facet joint disease is almost always associated with spinal stenosis for years before leg pain symptoms develop. Facet joint injections or “blocks” may provide useful diagnostic information which may help the spinal specialist determine the site of spinal pain and whether or not the facet joints are involved, in addition to providing short term relief of symptoms. The block may be performed at the level of the facet joint itself, or at the level of the ‘medial branch nerve’ supplying sensation to the joint. If pain recurs after a successful facet injection, additional procedures such as facet denervation or facet ’rhizotomy’ may be employed for long term relief of symptoms. Depending on the location, facet pain and pressure on neighboring nerves may cause ‘referred’ pain symptoms in the form of headaches, shoulder and arm pain, chest and rib pain, and leg or buttock pain.
What to expect:
Patients will enter the pre-op area where vital signs are taken. For those patients needing sedation an I.V. will be started and medications given. Patients will then enter the procedure room and lie face down on the procedural table with a pillow under the abdomen for lumbar procedures, or face up with a pillow under the head for cervical procedures. An x-ray machine will then be used to localize needle placement to the area(s) shown by imaging tests be responsible for the pain. The skin overlying the site of injection is cleaned with antiseptic solution, and covered with sterile drapes. Local anesthesia will be injected to numb the area where the injection will be performed, and the facet block needle is properly placed. At the completion of the procedure the needle is withdrawn and a bandaid dressing is applied.