CERVICAL, THORACIC, AND LUMBAR FACET BLOCKS

 Facet blocks consist of injection of local anesthetic and occasionally a steroid into a small joint space that connect adjacent vertebral bodies.  These joints have been shown to be lad bearing and have a stabilizing effect that prevents excessive rotation or forward slippage of the vertebral bodies.   Stresses on the facet joints can occur by sudden or repeated lifting and twisting motions of the lower back or neck leading to irritation or injury.  As we get older, arthritic changes may play a role in the development of facet syndrome.  In addition, each facet joint has a small nerve associated with it.  These nerves contain mostly sensory information.  The nerves supply the facet joints, ligaments, skin, and small muscles at each segment.  These are NOT the nerves that are responsible for movement and sensation in the extremities.  Blocking the facet joints and or nerves by either local anesthetics or Radiofrequency destruction produce relief of pain.  Facet blocks are both diagnostic and therapeutic for facet disease.

RADIO FREQUENCY LESIONING-NERVE DESTRUCTION OF FACETS

Radio frequency Lesioning is a simple and safe treatment for facet joint degeneration.  It is performed as an outpatient procedure under fluoroscopic (X-ray) guidance and mild sedation.  Using a specialized machine, pain signals to areas of the spine involving the small nerves to the facet joints are interrupted by heating these nerves.  The small nerves regenerate after about a year.  Clinical data shows that this method is effective in providing lasting pain relief.

HOW ARE THESE PROCEDURES PERFORMED

All procedures are performed a certified outpatient surgery center or hospital setting.  In most cases we use sedation techniques and use an Anesthesiologist.  Patients should have nothing by mouth including water for at least 6 hours prior to the procedure.  Regular medications (blood pressure etc.) can be taken with a sip of water.  You should not take any pain medications or sedatives prior to the procedure.  You will need a ride home and you should not drive yourself for at least 8 hrs after discharge.  You may return to normal activities the following day.

WHO SHOULD NOT HAVE THESE PROCEDURES

If you are on blood thinning medications (e.g. Coumadin, Plavix), or if you have an active infection or fever, you should notify the doctor immediately.  The procedure can be performed after a period of time when either blood thinning medication has been stopped, or when no active infection or fever is present.  If you are pregnant, you should not have these procedures.