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Medial Branch Blocks

Each level of the spine is connected to it neighboring level by a facet joint. Each joint is fed by two small branches of larger spinal nerves which are called medial branches.

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A medial branch block is an injection of local anesthetic near the two small nerves that feed a particular facet joint. A facet joint injection can be an alternative to the medial branch block. A medial branch nerve block temporarily interrupts the pain signal being carried by the medial branch nerves that supply a specific facet joint.

After local anesthetic is applied to the area of skin to be entered, a spinal needle is guided into the target area using fluoroscopy for accuracy and safety. Non-ionic contrast medium is then injected to ensure proper needle placement and to document that the vascular structures are not invaded. After certifying the proper needle placement a combination of local anesthetic and corticosteroid is injected into the target area to block the small nerves.

At MSPC, we use only the safest, time proven image guided methods to perform these procedures in the neck or back. All procedures are performed in a state-approved and Medicare-certified ambulatory surgery center with the most modern and sophisticated equipment to ensure safety and accuracy of needle placement during interventions.

Because patient comfort is of paramount importance at MSPC, interventions using MAC is an option offered. Local anesthetic is injected in the area to be entered even if monitored anesthetic care (MAC) is used in the center.

How long does this procedure take?

Usually, the medial branch block procedure will tale about 20 to 25 minutes from sterile preparation to completion. Additional time is needed for post procedure observation to ensure safe recovery from any adverse reactions.

What should I expect after medial branch blocks?

On occasion, your neck/back may feel numb or odd for a few hours after the injection. You may notice soreness from the injection sites as the numbing medication wears off.

How frequently may I have these procedures?

A series of two medial branch block injections is the usual recommended protocol. These are generally performed 2-3 weeks apart. If the patient has an appropriate response after the two medial branch blocks they may be a candidate for radiofrequency ablation.