Facet block

Special information on this examination

A facet block is an extremely sufficient method of treating therapy-resistant complaints in the area of thoracic and lumbar spine. If orthopaedic or physiotherapeutic methods did not bring much success, it is recommended to perform the PRT, since it unfolds its effect at the very site of pain.

An intervertebral disc protrusion, herniated disc or vertebral joints changed due to arthrosis can result in  inflammatory reaction of the downstream nerves. On the one hand, this reaction is responsible for pains in the spinal area, and on the other hand, for transmitted pains in the area of the abdominal wall, chest wall or legs (sciatica) as well. This inflammatory reaction is treated by means of an in situ administration of a small amount of only slowly resorbable cortisone preparation and then it should be cured. Here at our practice we treat a large group of patients due to the fact that we have been offering this therapy option for many years already. This is a low-risk, but highly effective method. An important thing for the statutory health insurance patients:

This treatment is completely reimbursed by the health insurance company.

How is the examination performed?

Before the beginning of the examination, CT or MRI findings will be discussed with the patient and a detailed anamnesis will be taken. During the so-called preoperative discussion, the symptomatic status will be determined and we will discuss with the patient how to eliminate the symptoms.

The treatment itself is performed on the following day at the earliest. During the procedure, the patient lying in the prone position is comfortably placed inside our computed tomography scanner. Then cross-sectional images of the disturbed segments are taken, in order to be able to make a plan of the treatment. Here the puncture angle and the depth of penetration of the needle will be determined, so that the puncture needle is placed as close as possible to the nerve roots without injuring them. After a thorough disinfection of the skin, the punctures are made according to the plan and, after rechecking the position of the needles, a medication cocktail, consisting of a local anaesthetic, pain reliever and a cortisone preparation, is injected.

After the puncture, the patient should stay in our practice for a couple of hours, in order to be able to detect eventual secondary reactions at an early stage.

What should the patients pay attention to?

Due to the fact that we inject a local anaesthetic or also a cortisone preparation directly beside the nerve roots, the power and responsiveness in the legs will be eventually reduced. As a result, you will be not allowed to drive for some time, so you should by no means drive back home all by yourself on the day of examination. You should be picked up by an accompanying person or use public transport. After the puncture, you should  have a rest in the practice for about 30 minutes and take a special care of yourself.

On the next day, all kinds of activities are allowed again. After the puncture, you may possibly feel some tingling in the skin segment where you previously had complaints. It is also normal, if you complain of numbness in your legs. This feeling of numbness will disappear on the following day. We would kindly ask you to inform us on the next day, to what extent the puncture has shown its effect.

What risks does the treatment involve?

Theoretically, there is a possibility of injuring the nerves. In the worst case, it would mean paralysis of the respective muscle structures. This complication has not occurred in our practice until now.

Furthermore, there is a possibility of a puncture-related infection of the puncture channel (accumulation of pus next to the spinal column) that should be treated antibiotically or even surgically. It has never occurred in our practice either.

In addition, there is a risk of haematoma formation directly beside the spinal column. For this reason, marcumar patients and those undergoing a therapy with blood thinners should necessarily inform us about that.