Complications of fluoroscopically directed facet joint nerve blocks: a prospective evaluation of 7,500 episodes with 43,000 nerve blocks Pain Physician, 03/29/2012

Manchikanti L et al. – This study illustrate that major complications are extremely rare and minor side effects are common.

• This study was carried out over a period of 20 months and included over 7,500 episodes or 43,000 facet joint nerve blocks.
• All of the interventions were performed under fluoroscopic guidance in an ambulatory surgery center by one of 3 physicians.
• The complications encountered during the procedure and postoperatively were prospectively evaluated.

• There were no major complications.
• Multiple side effects and complications observed included overall intravascular penetration in 11.4% of episodes with 20% in cervical region, 4% in lumbar region, and 6% in thoracic region; local bleeding in 76.3% of episodes with highest in thoracic region and lowest in cervical region; oozing with 19.6% encounters with highest in cervical region and lowest in lumbar region; with local hematoma seen only in 1.2% of the patients with profuse bleeding, bruising, soreness, nerve root irritation, and all other effects such as vasovagal reactions observed in 1% or less of the episodes.