Medial Branch Neurotomy – Diagnostic Procedure

Treating Your Pain

Back or neck pain may be due to problems with certain nerves near your spine. If so, a medial branch block can help relieve your pain. The treatment uses medication to numb the nerves near a problem joint for a few hours. This keeps some pain messages from traveling to the brain, and helps relieve your symptoms. Pain messages may travel along medial branch nerves from problem joints to your brain.

Getting Ready

To get ready for your treatment, do the following:

  • You will need to stop certain medications one week prior to your procedure. Please tell your doctor what medications you take (including aspirin and ibuprofen). Ask whether you should stop taking any of them before your treatment. This includes any vitamins, natural or herbal preparations.
  • Tell your doctor if you are pregnant or allergic to any medications.
  • Stop eating or drinking 6 hours before your appointment if this is a cervical (neck) procedure. If this procedure is for your lumbar spine, you may have a small snack/meal up to 2 hours prior to your procedure.
  • If asked, bring x-rays, MRIs or other tests with you on the day of treatment.

Your Treatment Experience

The treatment is done in a fluoroscopy room (x-ray imaging) at the VermontInterventionalSpineCenter. You will be asked to fill out a consent form prior to the procedure.

During the Procedure

You will lie on an exam table on your stomach or side depending on where the problem joints are located. During your treatment, the following will occur:

  • The skin over the treatment site will be cleansed with an antiseptic solution.
  • Each injection site will be numbed with an injection of local anesthetic which may cause a slight aching or burning sensation for a few seconds.
  • The doctor will place one needle next to each of the nervesrelated to the problem jointwhich may be causing your pain. The doctor will continue with this process until all problem areas have been treated.
  • A fluoroscopy (x-ray imaging) is used to help you doctor see the spine and guide the needle(s).
  • Once the needles are in place, the doctor will inject medication into the areas of the nerves. The purpose of this injection are to numb the problem area(s) for a few hours.

After the Procedure

Following the procedure, you will be advised to “test” the treatment. Testing the treatment means to resume your everyday routine/activities which would normally aggravate your problem areas. You will be instructed to contact the VermontInterventionalSpineCenter on the following day to report your results. You will be provided with a patient instruction sheet on what results are required.

You will need to have an adult friend or relative drive following the procedure. You may use a cold pack or ice if the injection site(s) become sore. This is normal and may last for a day or so.

When to Call Your Doctor

Call your doctor if you have a fever over 101 degrees Fahrenheit, chills, redness or drainage at the treatment site.

Risks and Complications:

Risks and complications are rare, but can include:

*Infection

*Increased pain, numbness, or weakness

*Nerve damage

*Bleeding

*Failure to relieve pain

Medial Branch Nerves

Each vertebra in your spine has facets (flat surfaces). They touch where the vertebrae fit together. This forms a facet joint. Each facet joint has at least two medial branch nerves. They are part of the nerve pathway to and from each facet joint. A facet joint in your back or neck can become inflamed (swollen or irritated). Pain messages may then travel along the nerve pathway from the facet joint to your brain.

Block Pain Messages

Medial branch nerves in each facet joint send and carry messages regarding back or neck pain. Numbing a few of these nerves can keep certain pain messages from reaching the brain and provide you temporary relief.

Should this procedure provide you relief for a period of time, the next step is to keep your scheduled Radiofrequency Procedure appointment. Following the Radiofrequency procedure, the treated nerves should relieve your pain for an extended period of time. Treated nerves most often redevelop within 6 months to a year. At that time, you may need a repeat treatment.

Relief from pain can help you enjoy your life again.