SPINE INJECTION-FACET JOINT MBB
SUMMARY
1. The lumbar medial branch block (MBB) is a purely diagnostic procedure, to determine whether a patient’s axial pain is caused by the facet joints under study.
2. Lumbar MBBs provide superior diagnostic specificity compared to intraarticular facet joint injections.
3. Lumbar MBBs have been shown to be target specific, with defined needle trajectories and target points[1]
2. Gofeld M, Faclier G. Radiofrequency denervation of the lumbarzygapophysial joints-targeting the best practice. Pain Med. 2008;9(2):204–211.
.
4. Lumbar radiofrequency neurotomy is typically performed after pain relief is reported following diagostic lumbar MBBs.
5. The electrode is positioned to lie parallel and over the medial branch nerve.
6. Because there is anatomic variation in the course of the medial branch nerve, many practitioners perform, at a minimum, two lesions at each level[2]
.
7. The volume of local anesthetic injected should be limited to 0.4-0.5 ml to maintain the diagnostic specificity of the injection.
Reference(s)
- ↑ Dreyfuss P, Schwarzer AC, Lau P, Bogduk N. Specificity of lumbar medial branch and L5 dorsal ramus blocks. A computed tomography study. Spine (Phila Pa 1976). 1997;22(8):895–902.
- ↑ Gofeld M, Faclier G. Radiofrequency denervation of the lumbarzygapophysial joints-targeting the best practice. Pain Med. 2008;9(2):204–211.
Furman, Michael B., and Leland Berkwits. Atlas of Image-Guided Spinal Procedures. Elsevier, Inc, 2017.
Horowitz AL. MRI Physics for Physicians. Springer Science & Business Media. (1989) ISBN:1468403338.
Mangrum W, Christianson K, Duncan S et-al. Duke Review of MRI Principles. Mosby. (2012) ISBN:1455700843.
