Introduction
The vertebrae or spine form the backbone. The vertebrae further have facet joints present on them. The facet joints have sensory nerve supplies for carrying messages to the brain. The facet joint is a synovial joint with a capsule and a synovial fluid. This topic elaborates on what facet joints are and what is facet joint block with the procedure, advantages, and side effects.
What Is a Facet Joint?
The facet joint is present between the vertebrae on the back of the spine. It connects each vertebra to the other. Facet joints are present in pairs, one on the side of the neck of vertebrae and the other on the back of vertebrae. It provides the backbone to move in bending, flexing, and twisting. They allow the back and neck to bend forward and backward. All the facet joints in vertebrae carry two small medial nerves that send messages to the brain. The facet joint is the only synovial joint in the spine. The synovial joint is where two bones meet, having thin cartilage covering and providing movement for a bone.
What Is the Use of Facet Joints in the Body?
Facet joints provide stability and support to the spine. Along with it, it carries a pair of sensory nerve branches. The sensory nerves are a medial branch of the posterior ramus of the spinal nerves. It sends pain signals to the brain on the injury of facet joints or conditions affecting facet joints such as arthritis.
What Is a Facet Joint Block?
A facet joint block blocks the facet nerve messages going to the brain. It is performed by injecting the anesthetic to numb the facet joint and the surrounding area. It relieves the pain in the patient’s backbone. It is done with the help of an X-ray or computerized tomography (CT) to guide the needle into the facet joint.
The facet joint block is used in the following cases:
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Inflammation.
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For pain relief.
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In rehabilitative exercises.
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To find the cause of back or neck pain.
How to Prepare for a Facet Joint Block?
The doctor will examine the patient before the block. The examination involves:
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Medical history of the patients.
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Blood tests for any clotting.
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Checking if the patient is on any medication on a regular basis.
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Allergy to anesthetics.
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The patient has to stop thinning blood medicines before the procedure.
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Wearing comfortable clothes during the procedure.
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The patient should remove any metal item before the procedure because of computerized tomography (CT) scan.
Who Can Perform Facet Joint Block?
A radiologist (a doctor specializing in radiology) or an anesthesiologist (a doctor specializing in giving anesthesia) can perform facet joint blocks at outpatient services. Outpatient services involve the clinic of a doctor or a radiology unit or a hospital center.
What Are the Steps Involved in Facet Joint Block?
The steps to perform facet joint block are:
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Initially, the patient is relaxed.
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Then the patient is made to lie on the belly.
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The patient's body parameters, like heart rate, blood pressure, and temperature, are checked.
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The back of the patient is cleaned with antiseptic solutions.
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The doctor will use contrast media (media used to identify the body tissues) to confirm the facet joint location.
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The doctor identifies the area on the backbone to insert the needle with the help of computerized tomography or X-ray guidance.
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The needle having anesthetic is inserted into the backbone of the facet joint.
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A small amount of anesthetic is injected initially to confirm the facet joint position.
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Some use steroids along with an anesthetic for more prolonged effectiveness.
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Some doctors inject the injection near the joint instead of into it.
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Soon the needle is removed.
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The doctor applies pressure to the area after removing the needle to prevent bleeding.
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And the area is bandaged.
The procedure takes nearly 30 minutes. Immediately after the anesthetic is injected, the doctors will start working. The patient feels numbness over the area and has a painless experience. Anesthesia can be maintained for two to four hours. After that, the patient starts feeling pain over the site when the anesthesia wears off. But the steroid can take a more extended period to work, nearly one week, and lasts for about three to four months.
What to Expect After the Procedure?
The patient feels numbness and a painless environment immediately after injecting the anesthetics. The site of injection can become sore after a few days. Applying an ice pack over the area can decrease the soreness. If sedatives are added to the injection, the patient is made to avoid driving for 24 hours.
Why Is a Facet Joint Block Given?
The primary function of facet joint block is to relieve the patient's pain at the facet joint by delivering anesthesia. The anesthesia that works immediately after use will block pain messages to the brain.
What Are the Side Effects of Facet Joint Block?
Side effects are:
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Infection can occur as the injection penetrates the skin of the patient.
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Allergic reactions to anesthetic can occur.
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Bleeding can be rare but possible.
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Nerve damage of the spinal nerve or paralysis.
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An X-ray can be dangerous for pregnant women. It is essential to know if the female patient is pregnant or not before taking the X-ray.
Is Facet Joint Block a Minimally Invasive Procedure?
Yes, facet joint block is a minimally invasive procedure. It uses a local anesthetic in injection to numb the site of the facet joint. It is a not-so-painful and not-so-bloody procedure. It affects only the small area covering the facet joint and the area surrounding it.
Conclusion
The facet joint is the synovial joint (joint between two bones containing synovial fluid and covered by cartilage). The facet joint in the backbone provides stability and support to the spine. Facet joint block is a minimally invasive procedure. It numbs the area of the facet joint and blocks the common facet nerves from sending nerve messages to the brain. These messages involve pain messages. They block the facet joint and relieve the pain of the patient. Local anesthesia, along with steroids, is used to provide a long period of relief from the pain in the backbone.
