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Facet Syndrome

WHAT ARE FACET JOINTS?

Facet joints are the connections between one vertebra and another adjacent vertebra. The actual structure between the upper and lower articular protrusions It is a joint and is located at the back of the spine. facet provides strength to the joints, bending and bending of the spine gives the ability. Joint, a thin surface layer of cartilage contains, is surrounded by a capsule and is filled with synovial fluid (cartilage) It is filled with a fluid that nourishes the spine and prevents friction between the two bone surfaces when the spine moves.

WHY IS FACET JOINT INJECTION USED?

There are simply two reasons for facet joint injection: has:
1. Diagnosis: Finding the source of the pain.

2. Tedavi: Tespit edilen bir anormalliği tedavi etmek.

A facet joint is identified as the source of the pain If used, anesthetic agents and anti-inflammatory drugs Therapeutic injections of medications can provide long-term pain relief.

HOW ARE INJECTIONS APPLIED?

Facet joint injections are administered locally while the patient is awake. while under anesthesia and able to communicate is applied. Sometimes your doctor will may use drugs to make you more comfortable. The injection is usually given face down on the x-ray table. It is performed while lying down.
Your doctor will examine the back area above the affected joint. It will clean and sterilize. During the application, be able to place the needle in the correct facet joint. Fluoroscopic x-ray will be applied to allow After careful placement, your doctor will local to numb the skin over the area will use anesthesia.
Facet joint injections are of 3 types:
  • 1. Intrafacet injection
  • 2. Nerve block innervating the facet joint
  • 3. Rhizotomy with thermocoagulation on the nerve innervating the facet joint
Intrafacet injection: 0.2 ml of contrast material is injected into the facet joint with a 22 G needle under fluoroscopy. Then, for diagnostic purposes, 1 ml 962 lidocaine or marcaine is injected. If long term If an effect is desired, local anesthetic can be used therapeutically. The substance is mixed with steroids and injected. This Its effect has a long-lasting effect. But injection high volume into the facet capsule during joint due to capsule rupture if injection is given may cause accelerated degeneration. This process Single level can be applied.
Nerve block innervating the facet joint: One facet joint 2 It is innervated by the nerve root. If a nerve block is to be performed, a 2 levels of blocks should be made for the joint. Block is local only depot with anesthetic for diagnostic and long-acting It is done with steroids. The event can last for 3-4 days or for months. It may also last.
Thermocoagulation of the nerve innervating the facet joint rhizotomy: If the pain is relieved with the nerve block, but If it recurs early, consider a long-acting nerve block. with a device called Radiofrequency generator to make Thermocoagulation is applied to the nerve. In this way, it is effective for months It is possible to achieve pain control.
This process is a congenital joint disorder (isthmic defect), in patients with unstable spondylolisthesis should not be applied. Because pain disturbs the patient Although it is a sensation, it is a sensation that indicates damage to the tissue. is an alarm. Increased listis and neurological deficit It may make it difficult to notice the emergence.
These methods reduce the pain associated with the facet joint due to the disc. It is very important in distinguishing it from pain. Facet joint pain It is also very effective in the treatment of selected cases.

ARE THERE ANY SPECIAL PREPARATIONS?

Once the appropriate area is decided, your doctor will anesthesia (lidocaine or bupivicaine) and anti-inflammatory (usually a corticosteroid) will be injected. Make sure the location of the injection is correct and Being able to decide whether injections are needed In terms of whether your pain is relieved or not, may be asked. This application applies to the affected facet joint. It can be repeated later depending on the number. Real Although the injection takes a few minutes, the overall The application usually takes 30-60 minutes.
Before receiving a facet joint injection 3 days, aspirin-like antiplatelet (blood thinner) You must not have received it. Also before injection You should not take prescription painkillers for at least 4 hours. Discuss all medical conditions with your doctor. On the day of injection, some doctors recommend Do not have food or drink (including water) for at least 4 hours suggests. But if you have insulin dependent diabetes inform your doctor; normal before application You may not need to change your eating habits.
You do not need to take medication within 4 hours before the application. If you feel it, it can be allowed with a small amount of water. Injection Talk to your doctor about restricted food and water needs beforehand.

WHAT HAPPENS AFTER INJECTION?

Waist or back pain immediately after surgery You may feel a decrease or complete improvement. Your doctor will evaluate the level of pain relief He or she may ask you to make a movement that will cause pain. Normally walking immediately after application you will be able to start. Some patients after injection unusually bad legs within a few hours They may feel weakness, numbness and aching. Reaction your period may be longer due to the drugs used in the application. may be affected and your driving may be affected by the injection. Immediately afterwards is not recommended. car after application You may need someone who can use it.
What you can feel at home at the injection site If any pain is relieved, use ice or a medication recommended by your doctor. You can treat it with painkillers. in injection The effect of the applied local anesthetic disappears. When you get up, your pain may return. steroid injection It takes 7-10 days for the ingredients to start relieving the pain. can take. After the first day, the pain will allow You can return to your daily activities as far as possible; but get their advice on specific activities that will be allowed Consult your doctor for Mostly, injection You can then return to your daily work.
Pain relief after the first therapeutic facet injection If there is no decrease, injection into the same area Subsequent treatments are generally not recommended.
Facet applied for the treatment of mild waist and back pain. The effectiveness of injections is controversial. Studies 9618-63 of patients receiving facet injections It has shown that there is relief in lower back pain for more than 6 months.

WHO SHOULD NOT RECEIVE FACET INJECTIONS?

If your pain is older than 4-6 weeks, conservative treatment if you have not tried other forms of treatments or if you have mild If you have lower back pain, use facet injections as a treatment. You shouldn’t take it. an anticoagulant medicine (coumadin and (such as heparin) and avoid excessive bleeding. If you are complaining, this application is not recommended. This kind If you are taking medications, you should tell your doctor. An infection or infection may be causing your back pain. If it is diagnosed as the result of malignancy, other practices used to alleviate pain are recommended.

ARE THERE ANY SIDE EFFECTS?

Incidence of side effects with any medical injection is as much as that of the application and its feasibility is Be sure to review it with your doctor before taking it. Possible complications from facet injections complications, pain at the injection site, bleeding, hematoma formation and infection. steroid used Side effects of the drug containing fluid retention, weight gain, include increased blood pressure, dizziness, and insomnia. Steroid side effects are usually temporary.
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