Thoracic facet joints are joints located in pairs in the mid-back. They provide stability and guide motion of the spine. Thoracic facet injection is an injection that is administered to the thoracic facet joint to reduce pain, improve flexibility, and enhance mobility in an individual.
Patient with thoracic facet joints pain and diseases are injected with thoracic facet joint injection to stop the pain. The injection can also decrease inflammation of the facet joints and prevent degenerative changes or deformity.
Who is the ideal candidate for Thoracic Facet Injection?
Thoracic facet injection should not be given to individuals with the following health conditions:
- Individuals with bacterial infections are not ideal candidates for thoracic facet injections.
- Individuals who are allergic to steroids or local anesthetics.
- Individuals who have infections of the spine or tumor.
- Individuals who have bleeding problems.
- Individuals with uncontrolled congestive heart failure or diabetes.
- Pregnant women.
Preparation for the Procedure
Before undergoing the procedure, you will need to consult with your doctor first. Let your doctor know of any health condition you have any medication you are currently taking. If you are on certain medications, you need to stop taking them.
There are some other medications that are allowed before the procedure such as medications for diabetes and blood pressure.
If you are on NSAIDs medications, you will have to stop taking them. Your doctor should know about any medication and health conditions for proper medical advice.
Do not eat any food or drink any liquid 2 hours before the procedure.
Take a shower with medicated soup before coming and wear loose clothing. Do not apply lotion on your skin.
Bring along your medical report and imaging scans.
Arrive at the hospital or clinic at least 30 minutes before the time of the procedure.
Come along with a family member or someone that will drive you back home after the procedure.
How the procedure is done?
You will be asked to lie down on your stomach on an examination table and rest your forehead onto a cut out the pillow with your arms positioned by the sides.
The doctor will then place a blood pressure monitor and pulse oximeter on your arm and finger. The skin around the area for the injection will be properly cleaned and disinfected with a cool iodine solution and a sterile piece of paper placed on your skin.
The doctor will place an X-ray over your spine to identify the right facet joints that need to be injected. You will be given a mild anesthetic to numb the area so as to reduce pain.
The doctor will then inject each facet joint with separate a needle using X-ray guidance to direct the needle to the exact location. A small amount of contrast dye is also injected to confirm the exact needle position before the steroid medication is injected.
After the doctor has injected each joint with the steroid medication, anti-inflammatory cortisone is then slowly injected to prevent inflammation.
When the procedure is completed, the doctor then slowly removed the needle and you will be transferred to a recovery area for further monitoring and observations.
After the procedure
After some minutes of observations, 20-30 minutes after the procedure, you will be asked to engage in some activities that increase pain in the affected areas. The result will be recorded. In the first few hours after the procedure, you may not feel any improvement, depending on the exact source of the pain.
Pain may also go away for a few hours and return after the anesthetic has worn off. You will need to record your progress in a pain diary.
You should get someone to drive you home because you can’t drive home by yourself due to the effect of the anesthetic and injection.
Follow every instruction given to you by your doctor or nurse when you get home.
You may resume less-strenuous activities for the remaining part of the day.
If you feel any discomfort, pain or swelling, apply ice packs.
You can take showers but don’t soak yourself in a tub for the next 24 hours after the procedure.
When you feel or see any signs of unusual symptoms or infections, report immediately to your doctor.
Report immediately to your doctor if you experience any of these symptoms:
- Sudden weakness
- Shortness of breath or palpitation
- Increased pain at the injection site
- Persistent redness at the injection site
- Discharged from the injection site
- Intractable headache
- Weakness of the legs, arm or face after the procedure
- Inconsistent or frequent stooling or urinating after the procedure
- High fever of over 101 degrees Fahrenheit.
Potential risks or complications of a thoracic facet injection
Just like every other medical procedure, there are some potential risks or complications that may occur. The potential risks patients may encounter from thoracic facet injection include;
- Temporary increase in the pain
- Tenderness at the affected area after the injection
- Allergic reaction to anesthetic or steroids
- Tissue injury
- Nerve damage
- Dural Puncture
- High blood sugar levels
- Transient vaginal spotting
- Transient facial flushing
- Vascular uptake of particulate steroid, cord ischemia
Infection rate is under 1% in patients getting spinal infusions performed under sterile conditions. Patients with a history of bleeding disorders are commonly faced with bleeding complications.
The recurrence of damage to the nerve roots or spinal rope has generously decreased with utilization of fluoroscopy and differentiation material. It is uncommon to experience nerve root or spinal string Injury with epidural infusions.
The rate of nerve damage and spinal rope damage is higher in fat patients because of poor representation of the objective on sidelong X-beams.
The dural cut is a rare confusion and may cause a positional cerebral pain. This sort of cerebral pain is regularly self-constraining, in spite of the fact that in steady cases, a blood fix might be important to ease the migraine.
When infusions are done in the thoracic zone, there is a probability that the spinal needle achieves the covering of the lungs and making a condition called pneumothorax which is ensnarement of air outside the lungs.