Background: Facet joint injection is considered an ideal diagnostic procedure for suspected facet joint syndrome. This study analyzed the facet joint injection arthrogram using fluoroscopy-guidance in the frequency and incidence of facetal epidural leakage during the procedure.

Method: For confirmation of an intra-articular injection 2 ml of contrast media was injected, and if an intra-articular injection was confirmed then 0.18% ropivacaine 4ml mixed with 40mg triamcinolone and Hyaluronidase 1500u were injected. This was a retrospective study and records from 2018 to 2019 resulted in 100 patients who underwent intra-articular facet joint block under fluoroscopy-guide with a total of 159 procedures. A total of 12 patients and 15 procedure were excluded because of concomitant epidural steroid injection. The arthrograms were analyzed to determine any epidural leakage during the intra-articular facet joint block by two pain physicians.

Result: During facet joint block, 50.6% had epidural leakage. 27 patients, 5 patients, and 1patient took anti-platelet, anti-coagulant or both respectively. No patient complained of any complication after the procedure.

Conclusion: Facet joint block could be a safe alternative for patients taking anti-platelet agents or anti-coagulants in delivering drugs to the epidural space.