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Thoracic Facet Nerve Block: Fluoroscopy 

Thoracic Facet Nerve Block: Fluoroscopy
Thoracic Facet Nerve Block: Fluoroscopy
Multimodality Imaging Guidance in Interventional Pain Management

Shrif Costandi

, Youssef Saweris

, Michael Kot

, and Nagy Mekhail


The benefit of intra-articular local anaesthetic and steroid injections for the diagnosis and treatment of facet joint pain is controversial. Thoracic facet medial branch blocks are mainly used to confirm the diagnosis of thoracic facet arthropathy. Anatomic variability is blamed for failed treatments. Conventionally, thermal radiofrequency (RF) has been used to denervate thoracic facet joints. Cooled radiofrequency ablation (c-RFA) of the thoracic medial branch is emerging as a novel promising technique that provides relatively larger lesions that could compensate for the anatomic variation of these branches and improve outcomes. The most feared complication of RF procedures in the thoracic region is pneumothorax, which may manifest as shortness of breath or pain with inspiration. Using proper technique for placement of the needles under fluoroscopic guidance renders the risk of this complication almost negligible.

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