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WHAT ARE FACETS?
The spine has highly sensitive joints connecting each vertebrae. In the low back these joints restrict your ability to tilt backwards and to rotate.
Lumbar Facet Evaluation helps to determine whether or not one or more of the lumbar facets are partly responsible for pain in the back, buttocks, hips and part way down the legs.
HOW IS IT DONE?
The evaluation can be done two ways:
One way is to block (temporarily anesthetize) the nerves that go to the facet joints felt to be the source of some pain. This is accomplished by placing a small amount of local anesthesia through a small needle at designated locations with the assistance of fluoroscopy (moving X- rays). Relief of pain only occurs if the facets studied are part of the pain pattern and the relief may last only an hour or so. This is strictly diagnostic. There can be false positives (pain relief) from the placebo effect and from spread of the local anesthesia to the wrong nerves.
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Another way is to place a small amount of local anesthetic and steroid into the facet joint. The amount has to be limited in order to have an accurate evaluation. The steroid can have a short term therapeutic effect as the steroid may relieve the pain for weeks and months.
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WHY DO IT?
If the facet evaluation provides significant pain relief, then one can consider doing a Radio Frequency Neurolysis, that is, heating the tiny nerves (medial branch nerves) to the facets to prevent transmission of pain for longer periods of time.
TIME?
The facet evaluation may take 30 to 45 minutes. Light sedation helps to make the patient comfortable during this procedure.
RISKS
There are minimal risks associated with this procedure.
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