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Lumbar Facet Block

What you should know

  • A lumbar facet block is a procedure to inject medicines at facet joints in the lumbar (lower back) area of your spine (backbone). This procedure is done to decrease inflammation (swelling) of these facet joints usually caused by accidents or spinal surgery. The swelling of these joints may cause long-standing pain in your lower back, buttocks, or legs. 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.

  • During the procedure, a thin needle is inserted along the lumbar 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 lumbar facet block, your long-standing back or leg 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 lumbar 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 to areas near the lumbar nerve and cause numbness in other areas. Even after a successful procedure, you may still have leg and lower 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.

Getting Ready

The week before your procedure:

  • Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.

  • Tell your caregiver if you have any allergies. These include allergies to food, dye, cleansing solution, such as iodine, or any numbing medicine.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your procedure. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before the procedure. You may need to check your blood sugar more often before and after having your procedure.

  • If you are a woman, tell your caregiver if you know or think you are pregnant.

  • You may need to have different blood and urine tests. Imaging tests, such as x-rays, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) may also be done. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your procedure:

  • Remove any nail polish.

  • You may be given a pill to help you sleep.

  • Ask caregivers about directions for eating and drinking.

The day of your procedure:

  • Write down the correct date, time, and location of your procedure.

  • What to bring: You may want to bring items such as a toothbrush and bathrobe.

  • Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

  • You will be asked to change into a hospital gown. You will be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the room where the procedure will be done. You will be asked to lie on your stomach, with your body slightly turned to the side. A pillow may be placed under your belly or you may be asked to bend one or both knees. Your lower back will be cleaned and covered with sheets to keep the procedure area clean. A medicine called local anesthesia will be given to help control pain during the procedure.

  • During the procedure, a thin needle will be inserted near your lumbar spine to the affected facet joint. Your caregiver will use an x-ray with dye or a computerized tomography (CT) scan to help guide the needle. He will place the needle tip inside or just outside the facet joint. When the needle is placed properly, your caregiver will inject medicines like steroids (medicines for inflammation) and long-lasting anesthesia. Your caregiver may insert another needle and inject medicines in other problem areas. After the procedure, the areas where needles were inserted will be covered with bandages.

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 keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your procedure to check your wound.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your appointment on time.

  • You have a fever.

  • You have a skin infection or an infected wound near the injured area of your spine.

  • You have questions or concerns about your procedure.

Seek Care Immediately if

  • The problems for which you are having the lumbar facet block get worse.

  • You have a lot more pain or discomfort.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Lumbar Facet Block (Precare)

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