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Lumbar Facet (Intraarticular) Block

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Interventional Pain

Abstract

Lumbar facet joint injections are performed for chronic facet-related low back pain. This chapter provides a step-by-step guide on how to perform this intervention safely and shows all the relevant C-arm and needle positions that needs to be demonstrated during the Fellow of Interventional Pain Practice (FIPP) exam administered by the World Institute of Pain (WIP). Both native and edited high-quality images are included, so the fluoroscopy anatomy is more easily understood.

Possible complications of the procedures and common reasons for failure at the FIPP exam are also outlined. Evidence for the procedure is provided based on the available literature reviewed by the Benelux section of WIP and also by the American Society of Interventional Pain Physicians (ASIPP).

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Suggested Reading

  • Ackerman WE, Ahmad M. Pain relief with intraarticular or medial branch nerve blocks in patients with positive lumbar facet joint SPECT imaging: a 12-week outcome study. Southern Medical Journal. 101(9):931–934.

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  • Cohen SP, et al. Effectiveness of lumbar facet joint blocks and predictive value before radiofrequency denervation. Anesthesiology. 2018;129:517–35.

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  • Cohen SP, Moon JY, et al. Medial branch blocks or intra-articular injections as a prognostic tool before lumbar facet radiofrequency denervation. Regional Anesthesia and Pain Medicine. 40(4):376–383.

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  • Kennedy DJ, Fraiser R, Zheng P, et al. Intra-articular steroids vs Saline for lumbar Z-joint pain: a prospective, randomized, double-blind placebo-controlled trial. 2019;20(2):246–251.

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  • Manchikanti L, Kaye AD, Soin A, et al. Comprehensive evidence-based guidelines for facet joint interventions in the management of chronic spinal pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines Facet Joint Interventions 2020 Guidelines. Pain Physician. 2020;23(3S):S1–S127.

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  • Patel VB. Intra-articular injections medial branch blocks and radiofrequency ablations. In: Diwan S, Staats PS, editors. Atlas of pain medicine procedures. New York: McGraw-Hill; 2015.

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  • Peh W. Image-guided facet joint injection. Biomed Imaging Interv J. 2011;7:e4.

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Author information

Authors and Affiliations

  1. Member, World Institute of Pain , King Fahad Medical City, Riyadh, Saudi Arabia

    Sarfaraz M. Khan

Authors
  1. Sarfaraz M. Khan
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Corresponding author

Correspondence to Sarfaraz M. Khan .

Editor information

Editors and Affiliations

  1. Member, Education Committee, World Institute of Pain, Vice Chair, Hungarian Section, World Institute of Pain, St Magdolna Private Hospital, Budapest, Hungary

    Agnes R. Stogicza

  2. Member, Education Committee, World Institute of Pain, Hospital Israelita Albert Einstein, Sao Paolo, São Paulo, Brazil

    André M. Mansano

  3. Past Chair, Education Committee, World Institute of Pain, Pain and Headache Center, Eagle River, AK, USA

    Andrea M. Trescot

  4. President-Elect, Past Chair, Examination Board, World Institute of Pain, National Spine and Pain Centers, Shrewsburry, NJ, USA

    Peter S. Staats

Additional information

The Lumbar Intra-articular Facet chapter was reviewed by Amitabh Gulati; Andrea M. Trescot; Milan Stojanovic; Peter S. Staats; Agnes R. Stogicza; Andre M. Mansano; Athmaja Thottungal and Raja Reddy.

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Cite this chapter

Khan, S.M. (2020). Lumbar Facet (Intraarticular) Block. In: Stogicza, A.R., Mansano, A.M., Trescot, A.M., Staats, P.S. (eds) Interventional Pain . Springer, Cham. https://doi.org/10.1007/978-3-030-31741-6_15

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  • DOI: https://doi.org/10.1007/978-3-030-31741-6_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-31740-9

  • Online ISBN: 978-3-030-31741-6

  • eBook Packages: MedicineMedicine (R0)

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