Complications of cervical facet procedures

Cervical facet joint pain is a frequent complaint seen in a pain clinic. Interventional treatment options are intra-articular injections, medial branch blocks, and radiofrequency ablation of the medial branch of the dorsal ramus. The side effects and complications of fluoroscopically directed facet joint nerve blocks were evaluated in a prospective study on 7500 episodes and 43 000 facet joint nerve blocks. Intravascular needle placement with infection of the superficial tissues and complications of local anesthetic with temporary weakness and numbness have been reported in patients who received cervical facet joint procedures. Spinal injection of local anesthetic during cervical facet joint injection resulted in unwellness and anxiety within 1-2 min after the injection. Other potential complications of facet joint interventions are related to needle placement and drug administration. Neural damage from direct needle trauma to the spinal cord and ventral rami during procedures done on cervical facet joints under appropriate image-guidance seldom occur.