Facet Joint Injection

Your referring physician has requested that you have facet joint injection. The following is a description of the procedure and a description of the potential complications, so that you may provide informed consent prior to the procedure. 

A facet joint injection is an invasive procedure with some uncommon risks. Facet joints are located on each side of the spine; they join the spine vertebrae together and allow the spine to move with flexibility. After local anesthesia (numbing medicine) is injected, a needle will be placed with fluoroscopic (x-ray) guidance into your facet joint or along the facet joint nerves. Occasionally, CT (or “CAT scan”) guidance may be used to help with needle placement. A small amount of contrast (x-ray dye) may be injected to help confirm the position of the needle. Typically a mixture of an anesthetic (numbing medicine) and a steroid will then be injected. Most complications of facet joint injections are uncommon and the procedure is very safe. You need to know the potential complications, which include: 

1. BLEEDING: As with all needle procedures, bleeding can occur. As long as you have no bleeding tendency and are not on any blood thinners such as Coumadin or Plavix, bleeding complications are extremely rare. Rarely, patients have had to undergo emergency surgery to relieve pressure on the nerve roots and spinal cord because of bleeding after spinal needle procedures like lumbar punctures.
2. INFECTION: Any needle through the skin can introduce infection. Infection is a rare complication, and sterile technique will be used to minimize the risk.
3. MUSCLE WEAKNESS OR BACK PAIN: Uncommonly, a nerve may be located immediately next to the injection site and may become anesthetized (numbed) or irritated. If this nerve supplies a muscle, it may cause weakness in that muscle. This weakness should be brief, probably only lasting up to 15 minutes or so. If this nerve becomes irritated, it may result in transient numbness or tingling or even back pain. Occasionally, your “typical” back pain may worsen. 
4. STEROID SIDE EFFECTS: Steroids injected at facet joints may rarely produce unwanted side effects. Some of these potential side effects include increased blood sugar or hyperglycemia (especially in diabetic patients), fluid retention, elevated blood pressure, and transient redness or facial flushing. (Side effects from steroids are more common if they are taken daily over a length of time, rather than as an isolated facet joint injection.)
5. ALLERGIC REACTION: The use of any medication, including x-ray contrast, has the possibility of producing an allergic reaction. Please inform your physician of your known medical allergies before the procedure. 

Please feel free to ask any questions you may have about the procedure prior to signing the consent form.