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Lumbar Medical Branch Block

What does “Lumbar Medial Branch Block” mean?

Here is what each word means:

  1. Lumbar: the area of the spine located in the low back
  2. Medial Branch: the small nerves which travel to the facet joint and makes the patient feel pain from the joint.
  3. Block: to block pain

Altogether, “Lumbar Medial Branch Block” means to block the nerves traveling to the facet joint to see if the pain is coming from the joint.

What is a Lumbar Medial Branch Block?

A Lumbar Medial Branch Block is an injecting done in the low back to target the nerves 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 Lumbar Medial Branch Block done?

  1. This procedure is often done to identify the facet joint as the cause of the patient’s low back 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 signals of pain. These are the same nerves which would be targeted by a Radiofrequency Rhizotomy of the Facet Joint.

What is the difference between a Lumbar Facet Joint Injection, a Lumbar Medial Branch block and a Lumbar Radiofrequency Facet Joint Rhizotomy?

  1. A Lumbar Facet Joint Injection is done by injecting a medication into the joint itself to treat inflammation.
  2. A Lumbar Medical Branch Block is done to diagnose if the patient’s pain is coming from the Lumbar Facet Joint. Instead of injecting medication into the joint, the small nerves traveling to the joint are blocked with a medication.
  3. A Lumbar Radiofrequency Facet Rhizotomy is done to disrupt the small nerves traveling to the facet joint in hopes of relieving pain for the longer term. These nerves are disrupted with heat rather than a medication.

How is a Lumbar Medial Branch Block done?

Here are the steps of how a Lumbar Medial Branch Block is done:

  1. The procedure is usually done in a Procedure Room or Operating Room.
  2. The patients often receive relaxing medication (sedation) intravenously (IV).
  3. The patient is positioned on their stomach (prone).
  4. The low back 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 advanced to the area of the nerve with the help of the X-Ray machine. The nerve is located next to the facet joint.
  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 Lumbar 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 Lumbar 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. During that time the doctor can verify that the facet joint is the source of the patient’s low back pain.