Facet Joint Injections - Anyone had success?

@amberrose I don't know if minimally invasive surgery is possible for decompression of the spinal cord. They have to be able to remove ostheophytes after removing the disc that is bad in order to gain access to the spinal canal. If it isn't a bad disc causing stenosis, they may be expanding the space inside the spinal canal by cutting and moving part of the vertebrae outward. Those discs are about an inch in diameter. With minimally invasive surgery, I believe the surgeon inserts a tiny tube to push the instruments through and it would limit access to being able to see the entire area internally. They have to make sure not to touch or move the spinal cord during surgery so as not to damage it.

I had this surgery at Mayo which was not minimally invasive for a bad C5/C6 disc with osteophytes and spinal cord compression. It wasn't that bad of a recovery. Most post surgical pain is in the first 2-3 weeks, and by 6 weeks, the incision is healed and I was feeling pretty good. At 3 months, the fusion process had started and I was able to forget I had spine surgery. I was in rehab because my neck muscles were weak after 3 months in a hard collar. I chose to do that because I could avoid having hardware on my spine entirely by staying in a collar until it fused. I had only a donor bone spacer. Often with hardware, surgeons may place a plate on the front of the spine to stabilize it. They probably cannot do that with minimally invasive procedures because they have to be able to screw it in place to connect 2 or more vertebrae in front. Only a surgeon can really answer that question.

I had an excellent surgeon and great results which is what brought me to Mayo Clinic as a patient. The skills of the surgeon are very important in the outcome of the procedure, so chose the very best you can. My surgeon was Jeremy Fogelson at Mayo in Rochester. I would recommend him if you are looking for a highly skilled compassionate doctor with extensive knowledge of spinal deformity. He does both fusion and artificial disc surgeries which is good to know if you are trying to decide between those procedures. Some surgeons only do fusions, etc.

Are you considering care at Mayo Clinic? You may use this link to contact any of the Mayo Clinic campuses to request an appointment. http://mayocl.in/1mtmR63

What recommendations have you had so far from your surgical consults?

I am scheduled to have cervical spine facet joint injections in mid-January.

This is my first attempt at any invasive procedure to help my neck pain, other than dry needling during PT and acupuncture.

I’m a bit apprehensive about starting this.

I wonder if anyone else has had these injections and did they help, not help, or make your neck pain worse? Would love to hear that many of you with neck pain have been helped.

I have arthritis, bones spurs and various other DDD (degenerative disc disorder) problems going on all along my spine but have been able to help myself improve with continuing PT exercises and core strengthening for the lower back.

I had injections in lower back like you are talking about. They were extremely painful and I got absolutely no pain relief. Just me🤷

Thanks, Jennifer for your information. Can you tell me what physical problems you were experiencing with the C 5-6 osteophytes and spinal cord compression?

I've had two facet injections in an attempt to solve a L3 nerve compression.
The first key is to note that the object is not to "cure" the problem, but to ease the pain to some manageable degree.....
Secondly, success if often followed by an ablation; the reason being that the lasting impact of the ablation is significantly longer.
I had about a 50% reduction in pain.
In the event that the ablation is not effective, the next step would be a spinal cord stimulator..

Good luck.

@amberrose I tracked changes in my symptoms on body diagrams so I could see how fast things were progressing with cervical stenosis with osteophytes and cord compression. During that time, I had a second MRI done 9 months after the first, and in that time, the amount of bone spurs doubled that were pressing into my spinal cord. At first, there were bone spurs on one side next to the ruptured disc in the spinal canal. 9 months later, there were bone spurs on the other side of the ruptured disc too.

I was also seeing a physical therapist at the time who was doing her best to keep my spine aligned properly from frequent muscle spasms that were twisting or tilting vertebrae independently. When that happened, I had a lot of neck pain, muscular headaches on the back and side of my head (occipital headaches), dizziness and vertigo, pain in shoulder blades, and pain and numbness in both arms and both hands. I had pain all over my body too, and it would change somewhat depending on the position of my neck. I had numbness and tingling in my forearms and hands, numbness in lower legs and feet, tingling in my calf, jumping muscles on the front of my thigh and in an opposite foot. I had an uneven gait when I walked with a slight limp and it was an intermittent problem when my vertebrae would slip a bit out of alignment. I also had issues emptying my bladder completely. When my therapist eased the muscle spasms and realigned my spine toward a normal curvature, I would walk normally again and the bladder was fine then until the next spasm. My disc had collapsed down about 50%, and if I side bent my neck either way, I sent a sharp pain down my arms toward that side. That was because the space between the vertebrae where the nerve roots exit the spine was much smaller and side bending would compress the nerves temporarily. I had deltoid pain, and had lost muscle there and in the triceps on the back of my arm and shoulder without realizing it. My PT mentioned it. Since surgery, I got some of that muscle back, but not all of it. There is probably a deficit of about 25% less than I used to have. I had some numbness in the sacral area too. Right before I had decompression surgery, if I bent my neck forward, I sent a big electric shock down my entire body.

What a lot of spine surgeons (five of them) missed in my case was that leg pain and problems walking were linked to a cervical cord compression problem. I had a bulging lumbar disc, and one also in thoracic that were asymptomatic, and there was no stenosis in other parts of my spine or in the foramen (the spaces between vertebrae where the nerve roots exit.) It seems a lot of surgeons can miss this link to leg symptoms, and that was the reason that I was denied surgery before I came to Mayo, because the surgeons were imagining some other kind of problem that their surgery couldn't fix. It really came down to that they didn't want a bad outcome on their record because they didn't understand my symptoms. I found medical literature with cases like mine right after the 5th denial, and none of my other doctors at that medical facility would help me address this with the last surgeon who missed it. I needed another opinion and I sent that medical literature in with my request to be seen at Mayo. I knew that the surgeon I sent that to would understand the connection to the symptoms because I read some of his literature that discussed leg pain with cervical stenosis. Had I known this, I could have saved myself two years if I had come to Mayo first.

This is the literature that explained cases like mine. It seems to be better known now, but it was described as a rare presentation back when my spine symptoms were becoming evident.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111492/

Spine surgery was not as bad as I had imagined. Waking up after surgery, all of the spine generated pain and symptoms were gone immediately, and the remaining pain was from the surgical path. I had a lot more intensity of pain and over a much longer time period with surgeries when I broke my ankle. I did have to do some rehab for weak neck muscles after that much time in a neck brace. I had a great recovery and I got my life back. I don't have any spine related pain. I chose to have a single level fusion with only a bone spacer and no hardware. I had donor bone because I didn't want my hip to hurt the rest of my life if they had taken a bone graft from it, and I thought that potentially could contribute to issues with balance when I am elderly. A surgeon has to be able to trust a patient to do this surgery without hardware, and I had to stay in a hard collar for three months until the fusion process began. That is the purpose of plates on the spine, to add stability while it heals and some peace of mind for the surgeon. Plates do contribute to the success of the fusion. I did just fine. I was very careful and followed directions and everything fused well.

Are you having some of the same symptoms?

Anyone had these? Did they work? Were they painful? Did you have sedation?

Anyone had these? Did they work? Were they painful? Did you have sedation?