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Thoracic Facet Joint Injection

What does “Thoracic Facet Joint Injection” mean?

Here is what each word means:

  1. Thoracic: area of the spine located in the mid-back
  2. Facet Joint: the small joint located on each side of the back of the spine

Altogether, “Thoracic Facet Joint Injection” means to inject medication into the small joint located on each side of the mid-back of the spine.

Why is a Thoracic Facet Joint Injection done?

Thoracic Facet Joint Injections are usually done to relieve pain and inflammation of the joint by injecting anti-inflammatory medications. Sometimes the injection is done to diagnose if the pain is actually coming from this joint.

What is the difference between a Thoracic Facet Joint Injection, and a Thoracic Radiofrequency Facet Joint Rhizotomy?

  1. A thoracic facet joint injection is done by injecting a medication into the joint itself to either diagnose the source of the pain or treat inflammation.
  2. A thoracic radiofrequency facet joint rhizotomy is done to disrupt the small nerves traveling to the facet joint in hopes of relieving pain for the longer term.

How is a Thoracic Facet Joint Injection done?

Here are some of the steps of how a Thoracic Facet Joint Injection is done:

  1. The procedure is usually done in a Procedure Room or Operating Room.
  2. The patients often receive relaxing medication (sedation) either by mouth or more commonly intravenously (IV).
  3. The patient is positioned on their stomach (prone).
  4. The mid-back (thoracic spine) is cleaned with a surgical antiseptic and sheets (drapes) are placed around the area to keep it clean.
  5. An X-Ray machine (C-Arm) is used to locate the facet joints in the spine.
  6. A small amount of local anesthetic may be injected under the skin.
  7. A specialized needle (spinal or procedure needle) is placed through the skin and advance into the joint with the help of the X-Ray machine.
  8. Sometimes a small amount of contrast material (fluid which looks dark on an X-Ray) is injected through the needle to verify that the tip is in the correct joint.
  9. At this point medication is injected into the joint.
  10. This could be a local anesthetic by itself, if the procedure is done to see if the joint is responsible for pain. In this case, the joint is “numbed up” for a period of time during which the patient is examined for pain. A steroid or other medication in combination with a local anesthetic can be injected for longer lasting relief. Some doctors inject medications which cause inflammation to treat this joint. This is called Prolotherapy. The idea is that causing inflammation will make the body send “repair chemicals” to the area which could repair and regenerate the joint.
  11. The needle is withdrawn.
  12. A band-aid is placed over the puncture.
  13. The patient is taken to a Recovery Area to be monitored.

How long does it take to do this procedure?

A Thoracic Facet Joint Injection can take 5-10 minutes to complete, depending on the number of joints injected.

What benefit can patients gain from the procedure?

The benefit from spine injections can vary. If the thoracic facet joint is the source of pain, Thoracic Facet Joint Injections can help for weeks to months. They may be partially effective or completely eliminate the pain.