Cervical Medial Branch Block

  • Purpose – This is a diagnostic test to see if pain is coming from the cervical zygapophyseal (facet) joints. 
  • Procedure Overview – The  cervical zygapophyseal (facet) joints receive nerve innervation through the medial branches.  This procedure numbs those nerves to see if a more permanent radiofrequency would be helpful.
  • Procedure Details – The patient is lying on their side.  A fluoroscopy machine (x-ray) is used to view the spine, and needle.  Multiple very small needles may be used.  A contrast dye is injected to confirm location before the local anesthetic (numbing agent) is injected.  The injection itself takes about  10 minutes.
  • Before the Procedure – The patient should arrive 15 minutes prior to the scheduled appointment to get prepared.  This involves a blood pressure check, consent, and if needed application of a hospital gown.  An antianxiety medication may be given if needed.  The patient will need a driver to bring them to and from the visit.  Blood thinners should be held from 5-7 days prior to the injection.  This would include nonsteroidal antiinflammatory drugs (e.g. ibuprofen, naproxen), aspirin, Plavix, Effient, warfarin, and Pradaxa.
  • After the Procedure – The staff will check vitals, and ensure there are no ill effects before discharge home.  If the area is sore then application of ice would be prudent for 20 minutes per hour until soreness is reduced.   The patient should pay close attention to the usual neck pain and determine how much relief they have received.  Pain relief from this usually lasts only a few hours.  If a patient has very good relief they may be scheduled for a radiofrequency ablation.

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