Cervical Facet Block

WHAT YOU SHOULD KNOW:

• A cervical (SER-vi-kl) facet (FAS-et) block is a procedure to inject medicines at facet joints in the cervical (neck) area of your spine (backbone). This procedure is done to decrease inflammation (swelling) and pain from these facet joints. The swelling of these joints may cause long-standing pain in your neck, shoulders, or arms. The spine is made up of bones called vertebrae that are like blocks placed on top of each other. The spine protects the spinal cord, and nerves coming to and from the spinal cord. Facet joints are found at the back of each vertebrae, one pair facing upward, the other facing downward. They have nerves inside and around them that may cause pain when they are damaged or pinched. The cervical facet joint is often damaged in a whiplash injury or after spinal surgery on the neck.
  
  
• During the procedure, a thin needle is inserted along the cervical spine to the facet joint. Your caregiver will first inject a small amount of anesthesia (numbing medicine). He may then inject medicine for inflammation. With a cervical facet block, your long-standing neck or shoulder pain may be treated, and you may resume your usual activities.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Having a cervical facet block may carry certain risks, such as infection and bleeding. Other parts near your spine, such as nerves, blood vessels, ligaments, muscles, and bones may be damaged. The medicines may spread past the problem area and cause numbness in other areas and you may have trouble breathing. Your lung may be punctured and you may have trouble breathing. Even after a successful procedure, you may still have shoulder or back pain. If left untreated, the pain and problems you have will continue to be there and may even get worse. You may have trouble going back to your usual activities. Call your caregiver if you are worried or have questions about your procedure, medicine, or care.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Local anesthesia: This is medicine to make you comfortable during your procedure. It is a shot of medicine put into the skin. It is used to numb the area and dull your pain. You may still feel pressure or pushing during the procedure.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

During your procedure:

• You are asked to lie on your stomach, with your head and body slightly turned to the side. Your neck, shoulders, and back are cleaned and covered with sheets to keep the procedure area clean. A medicine called local anesthesia is given to help control pain during the procedure.
  
  
• During the procedure, a thin needle is inserted near your cervical spine to the affected facet joint. Your caregiver may use an x-ray with dye or a computerized tomography (CT) scan to help guide the needle. If he is sure the needle is placed properly, he injects medicines like long-lasting anesthesia and steroids. Depending on your condition, your caregiver may need to insert another needle and inject medicines in other problem areas. Bandages or surgical tapes are then placed over the areas where needles were inserted.

After your procedure:

You may be taken to a recovery room to rest. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is OK. When caregivers see that you are OK, you will be taken back to your hospital room. The bandages used to cover your puncture keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your procedure to check your wound.

• Medicines: You may be given the following medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.