Facet block and/or SI-denervation
The vertebrae of the spine are stacked like blocks. These blocks hinge as they were relative to one another in the so-called facet joints. Slight changes might occur, caused by, for example, overloading, an accident or wear. These changes can cause pain. A facet block/SI-denervation can reduce this pain.
The vertebrae of the spine, both low in the lower back, and at the level of the thoracic and cervical spine, are stacked together as blocks. These blocks hinge as they were relative to one another in the so-called facet joints. Slight changes might occur, caused by, for example, overloading, an accident or wear in old age. These changes can cause pain. A facet denervation can reduce this pain. The treatment focuses on the sensory part of the nerve. The treatment has no effect on the motor part (= direction of movement) of the nerve. The pain conduction in the nerve branches is interrupted, by means of a very high-frequency current, which locally generates heat. Depending on the location of the complaints this happens: in the neck (cervical) at the level of the thoracic vertebrae (thoracic) low in the back (lumbar) at the level of the sacrum (sacroiliac joint)
Preparing for the treatment The treatment takes place in the OCP Medical Center. The treatment is performed by an anesthesiologist / pain therapist from the OCP Medical Center. You do not need to make any preparations at home unless specifically stated. You do not have to fast on the day of the treatment. You’ll arrive at the clinic about fifteen minutes before the treatment. An employee of OCP Medical Center guides to a waiting area. Before the procedure starts, a nurse and/or doctor will bring you to the adjacent treatment room. The treatment During the lumbar or sacroiliac joint treatment you lie on stomach, and during the cervical treatment you lie on your back, on the treatment table. Needles are placed at the nerve branches of the facet joints with the help of fluoroscopy. As soon as the needles are in the correct position, they are stimulated with faint electrical impulses. This way it can be ascertained whether the needles are placed close enough to the nerves of the facet joints. If this is the case then a small amount of anesthetic fluid (0.5-1 ml lidocaine 2%) will be injected. Then the tips of the needles will shortly be heated. The heat causes the nerve that goes to the joint to be partially disabled. As a result, the pain conduction in the nerve is interrupted. A facet denervation is often performed at multiple levels and often bilateral. The entire treatment takes about 15 minutes.
After the treatment People hardly experience side effects from the treatment and you can go home immediately after the treatment is finished. When the local anesthetic wears off (about 1 to several hours after treatment) some post-operative pain may occur. This is because needles are placed in an already irritated area. The pain may increase the first few days, however the pains usually does not last longer than a few days. You can take painkillers to help with the pain. This can be your own pain medication or paracetamol according to the dosage on the package leaflet. During the day of treatment it is advisable to take it easy. You may do what feels okay, but physical labour is strongly discouraged. Possible side effects Possible side effects are: Hematoma: this can occur if a blood vessel is damaged. This causes a bruise and sometimes also pain or discomfort. Muscle pain: on the location of the injection. Temporary loss of strength: this can last for several hours and is caused by the anesthesia. Temporary reduction of the sensation in the skin in the vicinity of the treated area, this is a result of the treatment and the sensation will come back on it’s own in a few weeks. Based on the cause of your pain, your specialist will assess if a physical treatment is necessary. Based on the medical history the necessity of additional tests will be decided.
Introducing our Pain Specialist
Introducing our Pain Specialist
Dr, Henk van Driel
Dr. Henk van Driel is operating as an anesthesiologist in the field of chronic pain for more than 25 years. After having initiated the pain management department in the Amphia Hospital in The Netherlands, the largest in the country, he opened Optimal Care Pijnklinieken back in 2008, the first clinic to offer the full range of pain management procedures available in The Netherlands.
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