64634 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)

Name of the Procedure:

Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint

Summary

This procedure aims to destroy specific nerves around the facet joints in the cervical (neck) or thoracic (upper back) spine using a neurolytic agent. Fluoroscopy or CT imaging guides the procedure to ensure precise targeting.

Purpose

This procedure addresses chronic neck or upper back pain originating from the facet joints. The goal is to alleviate pain by disrupting the nerve signals from the affected joints.

Indications

• Chronic neck or upper back pain not responding to conservative treatments
• Confirmed facet joint pain via diagnostic nerve blocks
• Candidates typically include those with pain affecting daily activities and quality of life

Preparation

• Patients may need to fast for several hours prior to the procedure.
• Medication adjustments, especially blood thinners, may be necessary.
• Pre-procedure imaging or diagnostic nerve blocks to confirm the source of pain.

Procedure Description

1. The patient is positioned appropriately, often lying face down.
2. The area is cleaned and sterilized.
3. Anesthesia is administered to numb the region.
4. Using fluoroscopy or CT imaging, the physician guides a needle to the target nerves.
5. A neurolytic agent is injected to destroy the nerves.
6. The procedure may be repeated for each additional facet joint.

Duration

Typically takes about 30 to 60 minutes.

Setting

Usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Interventional pain specialist or radiologist
• Nurses
• Radiologic technologists
• Anesthesiologist, if sedation is used

Risks and Complications

• Infection at the injection site
• Bleeding or bruising
• Temporary increase in pain
• Rarely, nerve damage or paralysis
• All potential risks will be discussed beforehand

Benefits

• Significant reduction in pain
• Improved mobility and quality of life
• Benefits can be realized within a few days to weeks.

Recovery

• Post-procedure rest and limited activity for the first 24 hours.
• Ice packs may be used to reduce swelling.
• Pain relief typically noticed within a few days.
• Follow-up appointments to assess effectiveness and plan further treatment if necessary.

Alternatives

• Physical therapy
• Medications for pain relief
• Other types of nerve blocks or injections
• Surgery, if conservative treatments fail

Patient Experience

• Mild discomfort during the procedure with local anesthesia.
• Possible soreness and temporary increase in pain following the procedure.
• Pain management with prescribed medications and rest ensures comfort during recovery.