Facet joint injection

Facet joint injection is traditionally performed using a blind technique. As techniques evolve, the use of CT or fluoroscopy imaging is now preferred because imaging guidance allows more precise needle placement. Once the entry site is selected, the needle is advanced anteriorly until the... 

Our needle guidance system has been evaluated [26,27] in a cadaveric study (Figure 4.5) to evaluate the system for facet joint injection. The... 

Clarke C, Moore J, Wedlake C, Lee D, Ganapathy S, Salbalbal M, Wikon T, Peters T, Bainbridge D. Virtual reality imaging with real-time ultrasound guidance for facet joint injection a proof of concept. Anesth Analg 2010 110(5) 1461-3. 

Glucocorticoids given intrathecally can cause a rise in cerebrospinal fluid protein and carry the risk of arachnoiditis (SED-8, 820). Chemical meningitis has been reported after two intrathecal injections of methylpredni-solone acetate (450) and after lumbar facet joint block (SEDA-17, 450). Intraspinal injections of hydrocortisone for multiple sclerosis apparently led in one case to a cauda equina syndrome, with subsequent ulceromutilating acro-pathy (SEDA-17, 450). Intra-discal injections of triamcinolone acetonide in a number of French cases led to disk or epidural calcification, sometimes symptomless (SEDA-17, 450). 

Figure 4.6 (a) Accurate placement of the needle tip in the facet joint, (b) real-time ultrasound is used to confirm needle placement, and (c) confirmation by radiopaque injectant in the X-ray image. 

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