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Medial Branch Blocks
Colin J. McCarthy, MB, BCh, BAO, MRCSI, FFR (RCSI); Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          • Outcomes

            TERMINOLOGY

            • Abbreviations

              • Medial branch block (MBB)
            • Definitions

              • Selective anesthesia of lumbar nerve medial branch in diagnostic evaluation of lumbar facet joint pain

            PREPROCEDURE

            • Indications

              • Contraindications

                • Getting Started

                  PROCEDURE

                  • Patient Position/Location

                    • Equipment Preparation

                      • Procedure Steps

                        • Findings and Reporting

                          • Alternative Procedures/Therapies

                            POST PROCEDURE

                            • Expected Outcome

                              • Things to Do

                                • Things to Avoid

                                  OUTCOMES

                                  • Problems

                                    • Complications

                                      Selected References

                                      1. Cohen SP et al: Effectiveness of lumbar facet joint blocks and predictive value before radiofrequency denervation: the facet treatment study (FACTS), a randomized, controlled clinical trial. anesthesiology. 129(3):517-35, 2018
                                      2. Han SH et al: Ultrasound versus fluoroscopy-guided medial branch block for the treatment of lower lumbar facet joint pain: a retrospective comparative study. Medicine (Baltimore). 96(16):e6655, 2017
                                      3. Manchikanti L et al: A systematic review and best evidence synthesis of the effectiveness of therapeutic facet joint interventions in managing chronic spinal pain. Pain Physician. 18(4):E535-82, 2015
                                      4. Cohen SP et al: Facet joint pain--advances in patient selection and treatment. Nat Rev Rheumatol. 9(2):101-16, 2013
                                      5. Cohen SP et al: Multicenter, randomized, comparative cost-effectiveness study comparing 0, 1, and 2 diagnostic medial branch (facet joint nerve) block treatment paradigms before lumbar facet radiofrequency denervation. Anesthesiology. 113(2):395-405, 2010
                                      6. Lee CJ et al: Intravascular injection in lumbar medial branch block: a prospective evaluation of 1433 injections. Anesth Analg. 106(4):1274-8, table of contents, 2008
                                      7. Manchikanti L et al: Lumbar facet joint nerve blocks in managing chronic facet joint pain: one-year follow-up of a randomized, double-blind controlled trial: Clinical Trial NCT00355914. Pain Physician. 11(2):121-32, 2008
                                      8. Manchukonda R et al: Facet joint pain in chronic spinal pain: an evaluation of prevalence and false-positive rate of diagnostic blocks. J Spinal Disord Tech. 20(7):539-45, 2007
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Preprocedure

                                          • Procedure

                                            • Post Procedure

                                              • Outcomes

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Medial branch block (MBB)
                                                • Definitions

                                                  • Selective anesthesia of lumbar nerve medial branch in diagnostic evaluation of lumbar facet joint pain

                                                PREPROCEDURE

                                                • Indications

                                                  • Contraindications

                                                    • Getting Started

                                                      PROCEDURE

                                                      • Patient Position/Location

                                                        • Equipment Preparation

                                                          • Procedure Steps

                                                            • Findings and Reporting

                                                              • Alternative Procedures/Therapies

                                                                POST PROCEDURE

                                                                • Expected Outcome

                                                                  • Things to Do

                                                                    • Things to Avoid

                                                                      OUTCOMES

                                                                      • Problems

                                                                        • Complications

                                                                          Selected References

                                                                          1. Cohen SP et al: Effectiveness of lumbar facet joint blocks and predictive value before radiofrequency denervation: the facet treatment study (FACTS), a randomized, controlled clinical trial. anesthesiology. 129(3):517-35, 2018
                                                                          2. Han SH et al: Ultrasound versus fluoroscopy-guided medial branch block for the treatment of lower lumbar facet joint pain: a retrospective comparative study. Medicine (Baltimore). 96(16):e6655, 2017
                                                                          3. Manchikanti L et al: A systematic review and best evidence synthesis of the effectiveness of therapeutic facet joint interventions in managing chronic spinal pain. Pain Physician. 18(4):E535-82, 2015
                                                                          4. Cohen SP et al: Facet joint pain--advances in patient selection and treatment. Nat Rev Rheumatol. 9(2):101-16, 2013
                                                                          5. Cohen SP et al: Multicenter, randomized, comparative cost-effectiveness study comparing 0, 1, and 2 diagnostic medial branch (facet joint nerve) block treatment paradigms before lumbar facet radiofrequency denervation. Anesthesiology. 113(2):395-405, 2010
                                                                          6. Lee CJ et al: Intravascular injection in lumbar medial branch block: a prospective evaluation of 1433 injections. Anesth Analg. 106(4):1274-8, table of contents, 2008
                                                                          7. Manchikanti L et al: Lumbar facet joint nerve blocks in managing chronic facet joint pain: one-year follow-up of a randomized, double-blind controlled trial: Clinical Trial NCT00355914. Pain Physician. 11(2):121-32, 2008
                                                                          8. Manchukonda R et al: Facet joint pain in chronic spinal pain: an evaluation of prevalence and false-positive rate of diagnostic blocks. J Spinal Disord Tech. 20(7):539-45, 2007