Facet Injections

Background

An injection of both long-lasting steroid and anesthetic numbing agent placed in a specific facet of the spine. The injection may be inserted inside the capsule or in the tissue surrounding the joint capsule. The facet joint is the movable joint of the spine that connects one vertebrae to another.

Anesthetic and cortisone mixture (green) is injected into the inflamed joint and surrounding tissue.

The cervical spine begins at the base of the skull. There are seven vertebrae in this area with eight pairs of cervical nerves responsible for controlling the neck, arms, and upperbody. This vertebral group is sturdy enabling it to support the weight of the head. The amount of stress placed on these vertebrae varies with movement.

General Pre/Post Operative Instructions

Patients may eat a light meal within 4-6 hours before the procedure. If patients are insulin dependent diabetics, they must not change their normal eating patterns prior to the procedure. patients may take their routine medications (i.e. high blood pressure, cardiac, thyroid and diabetic medication). Patient should not take pain medications or anti-inflammatory medications the day of the procedure. If patients are on Coumadin (blood thinners) or Glucophage (a diabetic medicine), they must notify the office so that the timing of these medications can be explained. Patients are generally asked to be at the facility one hour prior to the procedure and can be at the facility for approximately 2-3 hours. A driver must acompany the patient and be responsible for getting him/her home. No driving is allowed the day of the procedure.

During the Procedure

An IV is started so that relaxation medication can be given. The physician numbs a small area of skin with numbing medicine. The medicine will sting for several seconds. After the numbing medicine has taken effect, the physician will direct a small needle, using X-ray guidance into the epidural space. A mixture of numbing anesthetic and anti-inflammatory (steroid) medicine is injected. During this entire procedure you will be attached to various monitoring devices and will be asked to breath oxygen through your nose. This is all routine. The approximate time for the procedure is 30 minutes.

After the Procedure

Patients are returned to the post operative Same Day Surgery area where they are monitored for 60 minutes. A follow-up appointment will be made for a repeat block if indicated. These injections are usually done in a series of three (3), about two (2) weeks apart. The back of the legs may feel weak or numb for a few hours. This is to be expected, however it does not always happen. You will be given discharge instructions before you go home. Typically, improvement will occur within 48-72 hours following injection. There may be soreness at the site for 24-48 hours following an injection.