# Medial Branch Block

- Link: https://carolinaona.com/medial-branch-block/
- Published: 2019-02-13T23:19:03-05:00
- Author: Dallas Clifton

# Medial Branch Block

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### Medial Branch Block Overview

A medial branch block (MBB) is a minimally invasive diagnostic procedure that can
be used to diagnose facet mediated back and neck. Facet joints are in involved in
carrying weight through your back/neck and allowing motion of the spine including
flexion, extension and twisting. Facet mediated pain is often felt as a deep aching
worse with movement. Facet joint pain can be caused from numerous factors including
arthritis degenerative disc disease, falls and car accidents. Facet joints send 
pain signals through two medial branch nerves. Pain form the facet cannot be diagnosed
by x-ray, CT scan, MRI, or Bone scan.

## **What is a Medial Branch Block? **

An MBB is a minimally invasive diagnostic procedure that can temporarily relieve
neck or back pain caused by facet joints. Using precision guidance a small amount
of local anesthesia is placed directly on each medial branch. If the pain is coming
from the suspected facet joints the pain should decrease by blocking each branch
nerve. Generally, the MBB is effective for between 3-8 hours. If your pain is relieved
70% or more by the injection you may benefit form Radiofrequency Ablation, for longer-
term pain relief. If the relief is less than this amount, you may have another significant
spine disease that should be addressed with other therapies.

## **Prior to the procedure **

Patients who take blood thinner medication (Coumadin, Heparin, Plavix, Ticlid, Fragmin,
Orgaran, Lovenox, high-dose aspirin) may need to stop taking their medications prior
to the ESI. You must obtain approval from your prescribing physician prior to stopping
any medication.

 If you think you may be pregnant or are trying to get pregnant, please tell the
doctor. Fluoroscopy X-rays are used during the procedure may be harmful to the fetus.

Sedation is rarely necessary or used, but If it is used you must take nothing by
mouth for 4 hours prior to the procedure.

## **Day of the procedure: **

 * Plan to arrive 30 minutes before your scheduled appointment time.
 * We recommend that you have something light to eat before the appointment.
 * Make arrangements to have someone drive you to and from the office the day of
   the procedure.
 * The procedure generally takes 15-30 minutes followed by a recovery period.

## **Step 1: Prepare the patient**

The patient lays face down on the table, the skin is cleaned and the skin is numbed
with a local anesthetic.

## **Step 2: Insert the needle **

With the aid of a fluoroscope (a special X-ray), the doctor directs a needle through
the skin to the area of the facet joints. Fluoroscopy allows the doctor to inject
contrast and ensure correct placement of the needle.

## **Step 3: Inject the medication **

When the needle is in place, the medications are delivered on to each facet joint.
The needle is then removed.

## **Step 4: Recovery**

Most patients can walk around immediately after the procedure. After being monitored
for a short time, you usually can leave the office or suite. Someone must drive 
you home.

## **After the procedure**

Typically patients resume full activity the same day. Soreness around the injection
site may be relieved by using ice and taking a mild analgesic (Tylenol). The patient
may resume taking all medications immediately after the procedure.

You will be given a Post procedure pain diary to record your response to the MBB
over the first few hours.

## **What are the results? **

Generally, MBB will provide 3-8 hours of relief and depending on your response you
may be a candidate for a longer lasting procedure such as a Radiofrequency Ablation.

## **What are the risks? **

As with any procedure, there are both potential risks and benefits. MBB is generally
safe and serious complications are rare especially when using proper safety techniques
such as fluoroscopy. The potential risks associated with this procedure include 
anaphylaxis, headaches, spinal headache from a dural puncture, bleeding, infection,
allergic reaction, elevated blood pressure, nerve damage/paralysis (rare) and death.
Corticosteroid side effects may cause weight gain, water retention, flushing (hot
flashes), mood swings, insomnia, and elevated blood sugar levels in people with 
diabetes. Any numbness or mild muscle weakness usually resolves within 3-8 hours
in the affected arm or leg (similar to the facial numbness experienced after dental
work).

MBB should NOT be performed on people who have an infection, are pregnant, or have
bleeding problems.