Medial Branch Block

This diag­nos­tic pro­ce­dure is per­formed to iden­ti­fy a painful facet joint. The facet joints are the joints between the ver­te­brae in the spine. They allow the spine to bend, flex and twist. In prepa­ra­tion for the pro­ce­dure, the patient is posi­tioned on his stom­ach. The physi­cian injects a local anes­thet­ic. This numbs the skin and tis­sue around the facet joint that is sus­pect­ed of caus­ing the patien­t’s pain. Once this tis­sue is numb, the physi­cian inserts a nee­dle into the skin. The nee­dle is care­ful­ly guid­ed down to the facet joint. The physi­cian injects a con­trast solu­tion through this nee­dle. The con­trast solu­tion helps the physi­cian see the area on a cam­era called a flu­o­ro­scope, the flu­o­ro­scope pro­vides live x‑ray images. The physi­cian uses the flu­o­ro­scope to con­firm the loca­tion of the needle’s tip.

Once they have con­firmed that the nee­dle is posi­tioned cor­rect­ly, the physi­cian attach­es a syringe con­tain­ing an anes­thet­ic med­ica­tion. This med­ica­tion is inject­ed around small nerves called the medi­al branch nerves, these car­ry sig­nals to and from the facet joints. The anes­thet­ic will tem­porar­i­ly block sen­sa­tion in these nerves. If the tem­po­rary injec­tion relieves the patien­t’s pain, the physi­cian may inject a more long-last­ing anes­thet­ic. If the tem­po­rary injec­tion does not relieve the pain, the physi­cian may test near­by facet joints to iden­ti­fy the cor­rect one.

Click here to review an illus­tra­tion of the Med­ical Nerve Branch Block pro­ce­dure.
(Infor­ma­tion obtained from www​.viewmed​ica​.com 2012 Swarm Interactive).