Medial Branch Block.

This fact sheet relates to medial branch block injections, a type of back pain relieving injection which is performed at Melbourne Radiology Clinic.
The injection relieves pain by delivering local anaesthetic around the nerves responsible for supplying an arthritic or inflamed facet joint with sensation. A CT (Computed Tomography) scan will be used to guide the procedure.

Fact Sheets | Interventional Radiology | Back & Spinal Pain Injections

Medial Branch Block

Introduction

A Medial Branch Block is a test to help your doctor understand whether pain arising from your facet joints can be relieved by numbing the nerves (“medial branches”) that provide them with their sensation. If numbing these nerves results in significant pain relief, then the test is positive.

Preparation

01There is no specific preparation required.
02Bring along a support person / driver

We also strongly recommend that you bring a responsible person to drive you home afterwards.

NOTE:

Please discuss any medical illnesses with your doctor before booking the recommended procedure.

RISKS

Risks of spinal procedures are rare and include:
-Infection

most of these are minor (1-2%), however can be serious (<0.1%) requiring hospital admission, intravenous antibiotics and surgery.

-Bleeding:

this is fortunately also rare and slightly common in patients with bleeding disorders and on “blood thinning” medication. Blood thinning medications that you are currently taking should be ceased (Aspirin and Warfarin for 5 days, Plavix for 7 days and Iscover for 8 days).

As these medications constantly evolve with advances in medicine, the times to cease these medications may vary with newer medications. Should you be on different medications, please contact us or the doctor who prescribed the medication for further advice.

-Nerve damage:

from direct needle trauma, or as a consequence of the above mentioned complications.

-Dural puncture:

this is when the needle penetrates into the sac encasing the nerves within the spinal canal, causing leakage of fluid contained within the sac, known as CSF (cerebrospinal fluid), that may result persistent headaches. The risk of this procedure is approximately less than 1% and is treated with flat bed rest for two hours..

Procedure

CT Guided
Medial Branch Block

You will be asked to wear a gown with the selected area of the spine exposed. Medial branch injections procedures are completed with you either lying face down or on your side, in a CT scanner. We will ensure that you are as comfortable as possible.

A series of planning images are performed, with the area of needle entry planned on the computer terminal and then marked on your skin. The radiologist will then clean your skin with an antiseptic wash and inject local anaesthetic into the injection site. This results in a stinging sensation which is temporary until the skin becomes numb, usually taking 10 seconds.

A fine needle is then passed through the skin and tissues, constantly manipulated under CT guidance until it contacts the nerves that supply the facet joints with their sensation. Local anaesthetic is then administered which numbs these nerves. You will then need to keep a pain diary after the procedure and report back to your referring doctor. If the procedure is deemed a success, you may be eligible for radiofrequency ablation, which permanently destroys the nerves targeted in medial branch block injections.

Following your procedure & recovery

At most, you will feel some minor discomfort in the back. As local anaesthetic has been injected into the spine most patients will be pain free. Patients are able to walk freely after the procedure and are observed in the clinic for 10 minutes. Following this, you may be discharged if you are feeling well. You should not drive for the rest of the day. The following day you may return to work and gradually increase your activities.

Results &
Follow-Up

Your Images and Report

One of Melbourne Radiology Clinic’s specialist radiologists, a medical doctor specialising in the interpretation of medical images for the purposes of providing a diagnosis, will then review the images and provide a formal written report. If medically urgent, or you have an appointment immediately after the scan to be seen by your doctor or health care provider, Melbourne Radiology Clinic will have your results ready without delay. Otherwise, the report will be received by your doctor or health care provider within the next 24 hours.

Follow-up Appointment

Please ensure that you make a follow up appointment with your referring doctor or health care provider to discuss your results.

Your referring doctor or health care provider is the most appropriate person to explain to you the results of the scans and for this reason, we do not release the results directly to you.

Reminders

Previous Scans & Reports

Please bring to the clinic any prior scans (eg. X-rays, ultrasounds, MRI, CT) and reports as these will assist our radiologist in assessing your condition.

Any Referral Request Accepted

Please note that any referral for a scan is valid at Melbourne Radiology Clinic, even if it has been written or printed on a referral form or stationery supplied by another radiology provider.

If you have any further queries about your appointment please call Melbourne Radiology Clinic on (03) 9667 1667  – we are always only too happy to help.

Appointment Time

Whilst every effort is made to keep your appointment time, the special needs of complex cases, elderly and frail patients can cause unexpected delays. Your consideration and patience in these circumstances is appreciated.

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