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Evidence for the Use of Interventional Techniques for Chronic Spinal Pain
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
Laxmaiah Manchikanti, Vijay Singh, Elmer E. Dunbar
Safety of facet joint interventions with intra-articular injections and medial branch blocks has been demonstrated. The most common and worrisome complications of facet joint injections or nerve blocks are related to needle placement and drug administration. These complications include dural puncture, spinal cord trauma, infection, intravascular injection, spinal anesthesia, chemical meningitis, neural trauma, pneumothorax, radiation exposure, and hematoma formation.118–130 Steroid side effects were attributed to the chemistry or to the pharmacology of the steroids.129,130 Facet capsule rupture also may occur, if large volumes of injectate are used for intra-articular injections.67
Chronic Pain
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
Henry J. McQuay, Lesley A. Smith, R. Andrew Moore
Classically facet joint injection with local anaesthetic and steroid is indicated when pain is worse when sitting, and pain is provoked by lateral rotation and spine extension. Recent studies suggest that whether or not the injection is actually in the facet joint makes little difference,170 and indeed cast some doubt on long-term utility.171 Short-lived success (less than six weeks) with local anaesthetic and steroid is said to be improved by use of cryoanalgesia or radiofrequency blocks to the nerves to the joints.
Three-in-one procedure for failed spinal surgery improved pain, disability scores and serum inflammatory milieu: Three-years follow-up
Published in Egyptian Journal of Anaesthesia, 2021
Lumbar spine facet joint injection where the superior articular process connects to the base of the transverse process is the ideal site for medial branch infiltrations. [11] Injection mixture of corticosteroid and local anesthetic allows pain reduction [12] and proper selection of patient who may get benefit on thermal radiofrequency neurotomy (TRFN) [13] Efficacy facet joint injections depends on the anti-inflammatory and antiedematous effect of steroids in addition to its immunosuppressive action and to the inhibition of neural transmission within the nociceptive C fibers through reduction of lamina II GABAergic synaptic transmission resulting in a selective decrease in the processing of nociceptive inputs. [14]
Air embolism following peripheral intravenous access
Published in Baylor University Medical Center Proceedings, 2019
Myrian Noella Vinan-Vega, M. Rubayat Rahman, Jeremy Thompson, Misty D. Ruppert, Raj J. Patel, Amr Ismail, Sara Mousa, J. Drew Payne
In this case, the patient had onset of neurological symptoms shortly after a facet joint block. Air embolism has been reported following hip and greater trochanteric bursa injections but has not been encountered as a complication of facet joint blocks.10 Intravenous access was difficult to obtain for sedation prior to this patient’s facet joint injection. She had no other history of recent intravascular interventions, indicating that intravenous access was the most likely source of the air embolism.