Good review: https://pmc.ncbi.nlm.nih.gov/articles/PMC7713865/
Technique
- Patient Positioning: The patient lies prone on the fluoroscopic table and is rotated into an oblique position until the facet-joint space can be clearly seen.
- Skin Preparation and Local Anaesthesia: The skin over the facet joint is prepared and draped, then infiltrated with 1 percent lidocaine.
- Needle Insertion: A 90-mm, 22-gauge spinal needle is directed vertically into the joint space under the guidance of fluoroscopy.
- Confirmation of Needle Placement: Aqueous contrast material (0.2 to 0.5 ml, Omnipaque) is injected to confirm that the tip of the needle is correctly positioned within the joint.
- Therapeutic Injection: 2 ml of 1 percent lidocaine is then injected into the facet joint.
- Assessment of Pain Response: The patient's response to the lidocaine injections is assessed 30 minutes later using a second visual-analogue pain scale.
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