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  • Epidural/Facet block difference?

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    Old 03-25-2003, 03:13 PM   #1
    Nanner
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    Question Epidural/Facet block difference?

    I went to the NS who did my surgery last year and I am in a mess. First off, the nurse missed my name on the sign-in sheet, so I sat for longer than necessary in the lobby. Then I get a nurse I hadn't seen before, who didn't know a thing about my history and wasn't very good at listening to what I was trying to tell her.

    Then in comes the NS, and when I tell him I still feel lousy and my arm is getting more symptomatic, he pulls my head upwards and asks if that helps. Needless to say, I was rather tense when he did this, since he always told me not to let the PT do any manual traction! Now my neck feels sore, probably because my muscles were totally tensed when he did it.

    Anyway, I told him I was signed up to do epidurals starting next week. He asked if I meant facet blocks, but all I've heard used is the term epidural. So I asked the difference and he said facet blocks are shots into a useless nerve that only serves to register pain, basically killing off the pain message. Epidurals have some side effects, he says. Like what, I ask. "You can quit breathing", he says.

    SO...is he being an idiot just because I went to a PM doc? It seems that there are folks on this list who have had epis and lived to tell about it just fine.

    My questions are: does anyone have a handle on what the difference is between the two procedures (if any)? Also, for those who have had epidurals, what side effects were you warned about?

    The NS did order another EMG of my right arm and cervical spine, which I was expecting anyway. No mention of a follow up visit. I"m not sure I *want* a follow up with him at this point!

    ------------------
    Nancy D-ACDF C6-7 on 6/7/02. Donor bone with no hardware
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    Nancy D-ACDF 6/2/02, bladder suspension 12/06, sarcoidosis 10/07, TKR 9/3/13

     
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    Old 03-25-2003, 03:34 PM   #2
    BWL
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    Hi Nancy,

    I'm sorry you had such a downer of a visit today. Don't you just love the way the doc's just start moving your head around as if it's no big deal? My neuro almost lost his ability to have children by pulling that one on me.

    I believe the difference between the facet and epis are the location of the shot with the epi being in a more sensitive area. I'm surprised that your doc would be so against the idea.

    This link is for the Spinal Injection Society, click on the patient info link and they give a few details. Can you believe there is a spinal injection society??
    [url="http://www.spinalinjection.com"]http://www.spinalinjection.com[/url]

    I hope this helps!

    Feel well,
    Bruce



    ------------------
    ACDF with plating and donor bone C6-7 (1/29/03)
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    ACDF with plating and donor bone C6-7 (1/29/03)

     
    Old 03-25-2003, 05:18 PM   #3
    jbell95
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    Hi, I have had both. Two epidurals, one was in my SI joint for a fall on my bottom, 04/00 and the other one was for my neck and arm pain, 02/19/03. The Facet Block was also for the neck and arm pain, 03/06/02.

    The web site is a very good reference and will explain the procedures and the differences. I looked at this site too.

    Be sure to hydrate yourself really well. You will have an IV started for IV sedation if you choose. I did for both procedures.(possibly Versed) and IV fluids for either procedure. You'll want good veins. On 02/19, I was a bit dehydrated and it took THREE STICKS to find a vein. Must have been the IV God exacting revenge for all my missed sticks (smile) The only discomfort that I had was that I was nauseated and sick for the rest of the day. I made sure I was really hydrated for the Facet Block. I had lovely, plump veins that time and did not get sick.

    The same medication was used for both procedures, DepoMedrol. The only difference was location. I'm thinking that I got sick because I was dehydrated. Other than that, I didn't have any problems.

    Take care, J.



    ------------------
    C3-C6 straightening of normal cervical curvature.
    C2-T1 mild central spondylosis without significant stenosis.
    C3-C4 broad-based spondylosis and bulging with mild to moderate flattening of the anterior epidural space.
    C4-C5 broad-based spondylosis and bulging eccentric to the left with mild to moderate compression upon the anterior epidural space.
    C5-C6 spondylosis with a broad-based protrusion with moderate compression of the anterior epidural space.
    C6-C7 mild central spondylosis and a small midline protrusion with minimal flattening of the anterior epidural space.
    __________________
    01/27/03 Cervical MRI:

    C3-C6 straightening of normal cervical curvature.
    C2-T1 mild central spondylosis without significant stenosis.
    C3-C4 broad-based spondylosis and bulging with mild to moderate flattening of the anterior epidural space.
    C4-C5 broad-based spondylosis and bulging eccentric to the left with mild to moderate compression upon the anterior epidural space.
    C5-C6 spondylosis with a broad-based protrusion with moderate compression of the anterior epidural space.
    C6-C7 mild central spondylosis and a small midline protrusion with minimal flattening of the anterior epidural space.

    03/28/03 Myelogram/CT.

    04/02/03 Lumbar MRI:
    bulging disc L4-L5, DDD.

    04/24/03 Brain MRI.

    05/16/03 Nerve Conduction Studies.

     
    Old 03-25-2003, 05:27 PM   #4
    jbell95
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    Cool

    Here's another site
    [url="http://www.spine-health.com"]www.spine-health.com[/url]


    J.
    __________________
    01/27/03 Cervical MRI:

    C3-C6 straightening of normal cervical curvature.
    C2-T1 mild central spondylosis without significant stenosis.
    C3-C4 broad-based spondylosis and bulging with mild to moderate flattening of the anterior epidural space.
    C4-C5 broad-based spondylosis and bulging eccentric to the left with mild to moderate compression upon the anterior epidural space.
    C5-C6 spondylosis with a broad-based protrusion with moderate compression of the anterior epidural space.
    C6-C7 mild central spondylosis and a small midline protrusion with minimal flattening of the anterior epidural space.

    03/28/03 Myelogram/CT.

    04/02/03 Lumbar MRI:
    bulging disc L4-L5, DDD.

    04/24/03 Brain MRI.

    05/16/03 Nerve Conduction Studies.

     
    Old 03-26-2003, 05:27 AM   #5
    mel333
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    Hi Nancy,

    I have had 4 lots of facet blocks and found them somewhat helpful. I have not had an epidural but I had a nerve block which produced the best pain releif ever in my right arm and even helped ease the headaches. Facets can carry some of the load of a disc problem and often help with pain as they can be inflamed. It depends upon your pain but it does sound odd your dr didn't like them. According to ns's I have spoken to they are a good diagnostic test. Take care,

    Mel
    __________________
    23rd July 03, ADR c5/6
    Also disc bulges c3/4 and 6/7. Numerous facet and nerve blocks along with extensive conservative treatment prior to surgery.

     
    Old 03-26-2003, 06:52 AM   #6
    Nanner
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    Thanks for the feedback, Mel. I just scheduled the EMG for my arm on Tuesday, the day before the epidural. I figured it would be best done prior to the injections of the steroids.

    That yanking on my neck maybe did a bit of good. I do feel less tight back there today, but I would have preferred a massage to a neck pull! Not that it relieved my arm or head at all, but at least the neck feels more free.

    ------------------
    Nancy D-ACDF C6-7 on 6/7/02. Donor bone with no hardware
    __________________
    Nancy D-ACDF 6/2/02, bladder suspension 12/06, sarcoidosis 10/07, TKR 9/3/13

     
    Old 03-26-2003, 08:31 AM   #7
    BDW2
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    I'm not sure but I had a nerve root injectionin the left C 6-7 Foramen. The PM doc stuck about a 2.5 inch needle in my neck. That didn't really hurt because they are using a anesthetic for it. It did take him some time to get it positioned exactly where he wanted it in the foramen, but he did eventually. When he shot in the cortisone he asked me what I felt. It lit up my left arm in pain that reproduced all of my symptoms. His report said there was no doubt of the origin of my pain. So, diagnosticly it was great as for pain it helped moderately for a couple of weeks.
    Good Luck
    __________________
    ACDF C6-7 with plating and donor bone (3/28/03)

     
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