Monday, November 3, 2008

WHAT IS Neurotomy ?

Facet neurotomy is a procedure which results in interruption of the nerve supply to a facet joint. This interruption known as denervation, is accomplished by a radio-frequency probe that heats the 2 small nerve branches to each facet joint. These nerves are called the medial branches.


HOW IS IT DONE? A local skin anesthetic is given near the base of the neck on the affected side. A needle is inserted by the anesthesiologist near the transverse process of the cervical spine (usually at the
cervical-6 level). A sterile tubing is attached to the needle and anesthetic medication is slowly injected through the tubing.


EXPECTED RESULTS: The patient may note increased warmth and redness of the painful arm during and after the injection. The patient can expect hoarseness of their voice, redness of the eye, drooping of the eyelid and pupillary constriction for four to eight hours after the injection.
Pain relief may be noted immediately. Duration of relief is variable.
The patient must assess their pain relief over the first three to four hours after the injection and report this to the anesthesiologist.

HOW LONG DOES IT TAKE? It takes less than thirty minutes for the procedure followed by evaluation and recovery for several hours. Facet Block

WHAT IS IT? A block that is performed to confirm that a facet join is the source of pain and decrease pain and inflammation in a facet joint or joints.

HOW IS IT DONE? The patient is given a local skin anesthetic - a needle is then inserted into the facet joint or facet capsule and an anesthetic and steroid are injected by the physician. This is done under fluoroscopy.

EXPECTED RESULTS: Decrease in or relief of back pain.

HOW LONG DOES IT TAKE? Thirty minutes. Blocks are done in conjunction with physical therapy. Epidural Block


WHAT IS IT? A block that is performed to determine if a specific spinal nerve root is the source of pain and reduce inflammation around the nerve root thus decreasing or relieving the pain. HOW IS IT DONE? The patient is given a local anesthetic. The physician then locates, under fluoroscopy, a specific spinal nerve root. A needle is introducted through the skin into the area adjacent to the nerve root. Medication is then injected into the area bathing the nerve root. The medications include an anesthetic and steroid. A block that is performed under fluoroscopy to confirm a specific diagnosis and/or decrease pain and inflammation.


HOW IS IT DONE? A local skin anesthetic is given. A spinal needle is then inserted into the epidural space of the lumbar or caudal spine. An anesthetic and steroid are injected into the epidural space.

EXPECTED RESULTS: Relief of pain if the medication reaches the inflamed area or source of pain.

HOW LONG DOES IT TAKE? Thirty minutes plus approximately forty-five minutes recovery time. Selective Nerve Root Block

So at last it can be concluded that Neurotomy is a medical term. To cure it the patient is inserted a needle neat the base of the neck of the effected side and the process is performed very slowly. Thereafter the patient feel heat and redness of the infected area during the injection or after the injection.

1 comment:

rtusharkumarrastogi said...

Thanks Douglas, some good points. However, I disagree with the usefulness of local injections to localise disease. This is notoriously unreliable, and I think the saga of discograms has shown that. Also, if used for localisation of pathology, why not use local anaesthetic only, because I dont' think the steroids do anything?
Regards
https://www.kentmskclinic.co.uk/ultrasound-guided-spinal-injections/