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Pre/Post Op - Medial Branch Blocks


Medial Branch Blocks

Description of Procedure

A medial branch nerve block is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. Typically several levels of the spine are injected in one procedure.

If the patient experiences marked pain relief immediately after the injection, then the facet joint is determined to be the source of the patient's pain.

The procedure is primarily diagnostic, meaning that if the patient has the appropriate duration of pain relief after the medial branch nerve block, then he or she may be a candidate for a subsequent procedure - called a medial branch radiofrequency neurotomy (or ablation) - for longer term pain relief.

  • Worsening of pain symptoms
  • Discomfort at the point of injection
  • Bleeding. A rare complication, bleeding is more common for patients with underlying bleeding disorders
  • Infection. Minor infections occur in less than 1% to 2% of all injections. Severe infections are rare, occurring in 0.01% to 0.1% of injections
  • Nerve or spinal cord damage or paralysis. While very rare, damage can occur from direct trauma from the needle, or secondarily from infection, bleeding resulting in compression, or injection into an artery causing blockage.

If the area is uncomfortable in the first two to three days after the injection, applying ice or a cold pack to the general area of the injection site will typically provide pain relief. On the day after the procedure, patients may return to their regular activities. When the pain is reduced, it is advisable to start regular exercise and activities in moderation.

The goal of a medial branch nerve block is diagnostic, not therapeutic, so patients should expect their original pain to return after anesthetic phase.

One Medial Branch Block (MBB) will be performed and the patient should keep a log of back pain, leg pain, and/or any other problems. After the effects of the MBB wears off, or after 2 weeks minimum, the patient can return to have another MBB. Two successful MBB's must be preformed before the radiofrequency can be done. The patient must meet with doctor after these have been performed to discuss the ablation.

Post Operation

2-4 weeks after MBB or after effect of MBB wears off we usually repeat the MBB. After 2 successful MBB's, RFA would become an option but a follow up with the patient would be required before a RFA to evaluate the success. Patients need to keep a log of back and leg pain and other symptoms before and after multiple MBB's to ease the evaluation of the success.