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YOU are here : Home > Spinecare Topics > Intervention - Spinal Disorders > Minimally Invasive Intervention for Spine Pain
Spinecare Topics
Intervention - Spinal Disorders
Minimally Invasive Intervention for Spine Pain
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Minimally Invasive Intervention for Spine Pain
Current Medical: There is a vast amount of medical information implicating the facet joints as a significant cause of back pain. The use of diagnostic and therapeutic facet joint blocks has been used by pain management specialists and other spine specialists in the care of back pain. In the past this was often done without the benefits of image guidance. The facet joints are paired joints along the posterior aspect of each spinal disk level. They occur at each spinal level. These joints are synovial and subsequently have fluid in them. Each joint consists of an articulating surface between adjacent vertebra. They play a role in weight bearing and help provide stability to the spine. The facet joints contain a pain sensitive fibrous capsule as well as a specialized synovial membrane and fluid, referred to as synovial fluid. A thin layer of cartilage covers each surface of the facet joint. Each joint is bordered by a ligament in the multifidus muscle.
The fluid content of the joint as well as the thickness of the cartilage generally decreases with age. The specialized membrane of the facet joint and the thick capsule around the joint are innervated with countless sensory nerve fibers. Each spinal facet joint receives a nerve supply from adjacent spinal segments. The facet joint is susceptible to becoming inflamed secondary to systemic disorders such as rheumatoid arthritis.
The pain associated with a spinal facet syndrome is generally characterized by local tenderness over the region of a facet joint. Back pain increases with extension and rotation to the side of the involved joint. Facet pain in the low back is often associated with radiating pain to the hip or buttock region. Facet pain is also characterized by greater discomfort and stiffness in the morning that generally diminishes with increased activity. Facet pain usually improves to some degree with the use of an anti-inflammatory approach. If a local facet block or injection relieves pain it confirms the presence of pain arising from the facet joint.
Advanced imaging techniques often reveal abnormalities of the facet joints in the absence of pain. A facet joint block/injection may be recommended for diagnostic or therapeutic purposes. A proper diagnostic approach can help to eliminate unnecessary disk related surgical approaches.
Procedure: Facet injections are typically tolerated very well and are generally performed under local anesthetic. Some individuals may request IV conscious sedation. The patient who is under contrast sedation should be put under to a level where they can be aroused for questioning since sometimes a reporting of reproduction of pain can be extremely helpful in the selective and diagnostic process. Facet injections are generally preformed under image guidance such as X-ray fluoroscopy although computerized tomography may also be utilized.
The fluid content of the joint as well as the thickness of the cartilage generally decreases with age. The specialized membrane of the facet joint and the thick capsule around the joint are innervated with countless sensory nerve fibers. Each spinal facet joint receives a nerve supply from adjacent spinal segments. The facet joint is susceptible to becoming inflamed secondary to systemic disorders such as rheumatoid arthritis.
The pain associated with a spinal facet syndrome is generally characterized by local tenderness over the region of a facet joint. Back pain increases with extension and rotation to the side of the involved joint. Facet pain in the low back is often associated with radiating pain to the hip or buttock region. Facet pain is also characterized by greater discomfort and stiffness in the morning that generally diminishes with increased activity. Facet pain usually improves to some degree with the use of an anti-inflammatory approach. If a local facet block or injection relieves pain it confirms the presence of pain arising from the facet joint.
Advanced imaging techniques often reveal abnormalities of the facet joints in the absence of pain. A facet joint block/injection may be recommended for diagnostic or therapeutic purposes. A proper diagnostic approach can help to eliminate unnecessary disk related surgical approaches.
Procedure: Facet injections are typically tolerated very well and are generally performed under local anesthetic. Some individuals may request IV conscious sedation. The patient who is under contrast sedation should be put under to a level where they can be aroused for questioning since sometimes a reporting of reproduction of pain can be extremely helpful in the selective and diagnostic process. Facet injections are generally preformed under image guidance such as X-ray fluoroscopy although computerized tomography may also be utilized.
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