CT Guided Facet Joint/Nerve Root Injection
Definition
What is a CT guided facet joint/nerve root injection?
The injection consists of a mixture of an anaesthetic and a long lasting steroid either into the facet joints or nerve roots of the spine. Facet joints are located in the spine at each vertebral level. They are paired (right and left) and are surrounded by a joint capsule. Nerve roots are also found at each vertebral level at which nerves leave the spinal cord. Depending on the nature of your symptoms, the doctor will know whether to inject at the facet joint or nerve root. The steroid injected reduces inflammation at the site and thus reduces pain and the associated symptoms.
Will the injection hurt?
The procedure is done under local anaesthetic. There will be some discomfort, like a bee sting, as the local anaesthetic is injected.
How long does the procedure take?
The complete examination takes approximately half an hour.
Preparation
You can eat and drink as normal before the procedure.
If you have insurance, please ensure that you bring your policy number. You will need this when you register.
If you are in possession of a recent MRI scan you must bring it with you to your appointment. These scans are essential for the Radiologist to accurately plan your injection.
When making an appointment please inform the CT department of any allergies or blood thinning medication, such as Warfarin or Aspirin, that you may be taking. It is also important to tell the Doctor who performs the procedure of any allergies you may have.
The Procedure
Please report to the Diagnostic Imaging Department on arrival.
Once in the scanning room, the radiologist carrying out the procedure will talk to you about your symptoms and plan exactly where the injection will go. He will explain the procedure and ask you to sign a consent form. This is routine for all interventional procedures. Please inform him/her of any allergies at this time.
You will then be positioned on the scanning table. You will lie either on your back, your side or face down. An external marker will then be placed over the region of interest and a limited scan will be taken of that area to find the correct position for the injection. The skin is then marked and the area cleaned. It is very important that you do not move until the end of your examination.
The radiologist will then inject a small amount of local anaesthetic to numb the area. Once this has taken effect, he will place a longer needle into the site under image guidance he will guide the needle into the exact location and inject the medication. The needle may then need repositioning and another scan is taken.
The injection may cause a strange and uncomfortable stretching sensation which soon passes.
What should I expect after the injection?
Immediately after the injection, you may feel that you pain may be gone or significantly less. This is due to the local anaesthetic and will last for a few hours. You may resume normal activity as soon as you feel able however you may experience numbness and tingling on the affected side for up to 12 hours after the procedure. For this reason you should not drive following your procedure and we advise that you bring someone with you to escort you home.
After the local anaesthetic has worn off you may experience a worsening of your usual symptoms. This is due to the mechanical process of needle insertion as well as an initial irritation of the steroid itself. It may last for a couple of days. You should start noticing pain relief on the 3rd or 4th day after your procedure when the steroid begins to take effect. If pain persists beyond this time, an anti-inflammatory drug such as Ibuprofen is very effective at relieving the pain. You may also want to contact the Diagnostic Imaging department for additional advice.
Tel: +353 1 526 2060
How many injections do I need to have?
There is no guarantee that the treatment will be effective, but the majority of patients achieve good pain relief that can last several days to many months.
If the first injection does not relieve your symptoms in about a week or two, you may be recommended to have another. If you respond well to the first two injections but still have residual pain, you may be recommended for a third injection. This will be discussed with the radiologist.
What are the risks and side effects?
This procedure is well-established and safe when performed in a controlled setting. However, with any interventional procedure there are risks, side effects and a possibility of complications. Risks include infection, worsening of symptoms and bleeding.
The most common side effect is temporary discomfort and numbness in the area injected.
Contacting us
If you have any questions about your examination or there is something you think we should be aware of prior to your procedure, please contact the Diagnostic Imaging Department:
Tel no: 01 526 2060
Fax no: 01 526 2061