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Cervical Medial Branch Block Injection

What does “Cervical Medial Branch Block” mean?

Here is what each word means:

  1. Cervical: the area of the spine located in the neck
  2. Medial Branch: the small nerve which travels to the facet joint and makes the patient feel pain from the joint.
  3. Block: to block pain

Altogether, “Cervical Medial Branch Block” means blocking the nerve traveling to the facet joint in the neck so that pain from the joint is not felt.

What is a Cervical Medial Branch Block?

A cervical medial branch block is an injecting done in the neck to target the nerve traveling to the facet joint. The injection is done to numb up (anesthetize) the joint. After it is numbed, the doctor can find out if the pain was coming from the facet joint.

Why is a Cervical Medial Branch Block done?

  1. This procedure is often done to identify the facet joint as the cause of the patient’s neck pain.
  2. This procedure is also done to help predict if a Radiofrequency Facet Joint Rhizotomy could provide pain relief. This procedure targets the Facet Joint nerve (medial branch) and disrupts its pain signals.

What is the difference between a Cervical Medial Branch Block, a Cervical Facet Joint Jnjection and a Cervical Radiofrequency Rhizotomy of the facet joint?

  1. A Cervical Medial Branch Block is an injection which uses local anesthetic to anesthetize the nerves traveling to the facet joint. This is done to help diagnose if the pain is coming from the facet joint.
  2. A Cervical Facet Joint Injection is done to deliver medication into the facet joint to help with pain and inflammation.
  3. A Cervical Radiofrequency Rhizotomy of the Facet Joint uses targeted heat energy to disrupt the small nerves traveling to the facet joint. The goal is to provide the patient with long lasting pain relief.

How is a Cervical Medial Branch Block done?

Here are some of the steps of how a Cervical Medial Branch Block is performed:

  1. The procedure is usually done in a Procedure Room or Operating Room.
  2. The patients often receive relaxing medication (sedation) either by mouth or more commonly intravenously (IV).
  3. The patient is positioned on their stomach (prone) or on their stomach (supine) with the head turned. Another position has the patient be on their stomach. This is dependent on the preference of the doctor.
  4. The neck is cleaned with a surgical antiseptic and sheets (drapes) are placed around the area to keep it clean.
  5. An X-Ray machine (C-Arm) is used to locate the facet joints in the spine.
  6. A small amount of local anesthetic may be injected under the skin.
  7. A specialized needle (spinal or procedure needle) is placed through the skin and advance to the area of the nerve with the help of the X-Ray machine. The nerve is located next to the wider part of the vertebra on the back of the spine (lateral mass).
  8. Sometimes a small amount of contrast material (fluid which looks dark on an X-Ray) is injected through the needle to verify that the tip is in the correct location.
  9. At this point medication a local anesthetic is injected around the nerve.
  10. The needle is withdrawn.
  11. A band-aid is placed over the puncture.
  12. The patient is taken to a Recovery Area to be monitored.

How long does it take to do a Cervical Medial Branch Block?

This procedure usually takes 5-10 minutes to complete depending on how many nerves are targeted.

What kind of benefit can patients gain from a Cervical Medial Branch Block?

This procedure is done for diagnosis. The pain is only expected to be relieved for a number of hours depending on what type of local anesthetic is injected. However, the benefit to the patient is that the source of the pain can be identified.