Show Summary Details
Page of

Facet Joint Interventions: Fluoroscopy 

Facet Joint Interventions: Fluoroscopy
Facet Joint Interventions: Fluoroscopy

David Jamison

, Indy Wilkinson

, and Steven P. Cohen

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2021. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 17 January 2021

This chapter reviews the diagnosis and treatment of facet joint pain. Fluoroscopic guidance is commonly used to optimize treatment outcomes. The only reliable way to identify a painful facet joint is with image-guided blockade of either the medial branch innervating the joint or the joint itself. Although computed tomography (CT) and ultrasound have been shown to provide reliable landmarks for accurate needle placement, these modalities have limitations. The risks of CT include increased radiation exposure, cost, and an inability to perform real-time contrast injection. While ultrasound provides a convenient and inexpensive way to anesthetize the facet joints or medial branch nerves innervating them, it is unreliable in obese patients, is not as sensitive for detecting intravascular uptake as digital substraction or real-time contrast injection under fluoroscopy, and cannot be reliably used to place an electrode parallel to the course of the nerve, which has been shown to enhance lesion size.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.