Medial Branch Block and Neurotomy

What Are Medial Branch Block and Neurotomy?

Facet joints connect the vertebrae in your spine and help with movement and stability. When these joints become inflamed or damaged, they can cause chronic pain. Medial branch nerves carry pain signals from the facet joints to the brain.

• Medial Branch Block: A diagnostic procedure that temporarily numbs the medial branch nerves to determine if they are the source of your pain.
• Radiofrequency Medial Branch Neurotomy: A treatment that uses radio waves to heat and damage these nerves, blocking their ability to send pain signals to the brain and providing longer-lasting relief.

How Is the Procedure Done?

Medial Branch Block

1. The skin at the injection site is numbed with a local anesthetic.
2. A small needle is inserted into the numbed area using fluoroscopy (live X-ray) for precise placement.
3. Medication is injected onto one or more medial branch nerves to numb them temporarily.

If you experience significant pain relief for 4 to 6 hours after the procedure, it indicates that these nerves are likely contributing to your pain. This diagnostic step helps determine if a neurotomy is appropriate.

Medial Branch Neurotomy

1. The skin at the treatment site is numbed with a local anesthetic.
2. A specialized needle is guided into place using fluoroscopy.
3. Radio waves are sent through the needle to heat the targeted nerve for 60 to 90 seconds, disrupting its ability to send pain signals.
4. This process may be repeated for multiple nerves as needed.

How Long Do the Procedures Take?

• Medial Branch Block: The procedure typically takes 20 to 30 minutes, followed by a short observation period before you go home.
• Medial Branch Neurotomy: Depending on the number of nerves treated, this procedure takes 45 to 90 minutes, with an observation period of 30 to 60 minutes afterward.

What to Expect After the Procedure

Medial Branch Block

• Temporary relief lasting a few hours.
• Helps determine if the medial branch nerves are the source of your pain.

Medial Branch Neurotomy

• Some soreness or tenderness at the injection site.
• Pain relief often begins immediately or shortly after the procedure and can last for several months.
• If pain returns, it may indicate that the nerve has healed or that another nerve is causing pain.

Follow-up care is essential for monitoring results and exploring further treatment options if needed.

Benefits of Medial Branch Block and Neurotomy

• Minimally Invasive: Both procedures involve small incisions and minimal recovery time.
• Effective Pain Relief: Neurotomy provides longer-lasting relief compared to temporary measures.
• Targeted Diagnosis: The medial branch block identifies the exact source of pain before proceeding with treatment.
• Quick Recovery: Most patients return to normal activities shortly after the procedure.