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Thoracic Facet Joint Interventions

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Essentials of Interventional Techniques in Managing Chronic Pain

Abstract

Pain in the mid back and upper back secondary to facet joints has been shown to be present in 34–48% of patients with chronic thoracic pain. Chronic thoracic facet joint pain is generally treated with either facet joint nerve blocks or radiofrequency neurotomy.

The awareness that facet joints can be a cause of chronic mid back and upper back pain is a relatively recent development (since 1987). With appropriate investigations, using controlled diagnostic medial branch blocks, thoracic facet joints have been established as sources of mid back pain, upper back pain, and referred pain into the chest wall and abdominal wall in patients with chronic thoracic pain (evidence Level II). The evidence for therapeutic facet joint nerve blocks is Level II; the evidence for radiofrequency neurotomy is Level IV. There is no established evidence for managing chronic thoracic pain with therapeutic intra-articular injections.

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Acknowledgments

This book chapter is modified and updated from a previous book chapter, “Thoracic Facet Joint Interventions” by Laxmaiah Manchikanti, MD, David M. Schultz, MD, and Frank J.E. Falco, MD, in the Interventional Techniques in Chronic Spinal Pain published by ASIPP Publishing. Permission has been obtained from ASIPP Publishing.

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Authors and Affiliations

  1. ASIPP and SIPMS, Paducah, KY, USA

    Laxmaiah Manchikanti

  2. Pain Management Center of Paducah, Paducah, KY, USA

    Laxmaiah Manchikanti

  3. Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA

    Laxmaiah Manchikanti

  4. Medical Advanced Pain Specialists Medical Pain Clinics, Shorewood, MN, USA

    David M. Schultz

  5. Millennium Pain Center, Bloomington, IL, USA

    Ramsin M. Benyamin

  6. College of Medicine, University of Illinois, Champaign-Urbana, IL, USA

    Ramsin M. Benyamin

  7. Mid Atlantic Spine and Pain Physicians, Newark, DE, USA

    Frank J. E. Falco

  8. Temple University Hospital, Temple University Medical School, Philadelphia, PA, USA

    Frank J. E. Falco

Authors
  1. Laxmaiah Manchikanti
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  2. David M. Schultz
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  3. Ramsin M. Benyamin
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  4. Frank J. E. Falco
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Correspondence to Laxmaiah Manchikanti .

Editor information

Editors and Affiliations

  1. Pain Management Center of Paducah, Paducah, Kentucky

    Laxmaiah Manchikanti

  2. Department of Anesthesia, LSU Health Science Center, New Orleans, Louisiana, USA

    Alan D. Kaye

  3. Mid Atlantic Spine and Pain Physicians, Newark, Delaware

    Frank J.E. Falco

  4. Service Line Chief of Interventional Radiology, Director of Interventional Neuroradiology, Chief of NeuroInterventional Spine Service, Massachusetts General Hospital, Boston, Massachusetts, USA

    Joshua A. Hirsch

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Manchikanti, L., Schultz, D.M., Benyamin, R.M., Falco, F.J.E. (2018). Thoracic Facet Joint Interventions. In: Manchikanti, L., Kaye, A., Falco, F., Hirsch, J. (eds) Essentials of Interventional Techniques in Managing Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-60361-2_20

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  • DOI: https://doi.org/10.1007/978-3-319-60361-2_20

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