Medial Branch Neurotomy


medial_branch2Medial Branch Nerves
Each vertebra in your spine has facets (flat surfaces). They touch where the vertebrae fit together. This forms a facet joint. Each facet joint has at least two medial branch nerves. They are part of the nerve pathway to and from each facet joint. A facet joint in your back or neck can become inflamed (swollen and irritated). Pain messages may then travel along the nerve pathway from the facet joint to your brain.

Blocking Pain Messages
Medial branch nerves in each facet joint send and carry messages about back or neck pain. Destroying a few of these nerves can keep certain pain messages from reaching the brain. This can help bring you relief.

Treating Your Pain
Back or neck pain may be due to problems with certain nerves near your spine. If so, a medial  branch neurotomy can help relieve your pain. The treatment uses heat, cold, or chemicals to destroy the nerves near a problem joint. This keeps some pain messages from traveling to the brain, and helps relieve your symptoms.

Getting Ready
To get ready for your treatment, do the following:

  • • At least a week before trealmenl, tell your doctor what medications you take (including aspirin).
  • • Ask whether you should stop taking any of them before treatment.
  • • Tell your doctor  if you are pregnant or allergic to any medications.
  • • Stop eating or drinking 8 hours before you check in for your treatment, or as directed.
  • • lf asked, bring x-rays, MRls, or other tests with you on the day of the treatment

Your Treatment Experience
The treatment is done in a hospital or surgery center. You'll be asked to fill out some forms, including a consent form. You may also be examined. You may be given an IV (intravenous)line for fluids and medications.

During the Procedure
To help you relax, medication may be given through the IV line. You will lie on an exam table on your stomach, back, or side. This depends on where the problem joint is. During your treatment

  • • The skin over the treatment site is cleaned and then numbed with medication.
  • •  Fluoroscopy (x-ray imaging) is used to help your doctor see the spine and guide the treatment. A contrast "dye" may be injected into the affected region to help get a better image.
  • • Heat, cold, or chemicals are used to destroy part of the nerve near the inflamed facet joint. Other nerves nearby may also be treated.

After the Procedure
Most often, you can go horne in about an hour. Have an adult friend or relative drive you. The treated spot may be swollen and may feel more sore than usuaL This is normal and may last for a day or so. lt will be a few days before you feel relief from your symptoms. Your doctor may prescribe pain medications for you during that time. Ask him or her when it's okay for you to go back to work.

When to Call Your Doctor
Call your doctor if you have a fever over 101°, chills, or redness or drainage at the treatment site.

Risks and Complications
Risks and complications  are rare, but can include:

  • • Infection
  • • Increased pain, numbness, or weakness
  • • Nerve damage
  • • Bleeding
  • • Failure to relieve pain

Discussing the Results
Relief from pain can help you enjoy your life again. tet your doctor know if you still have pain after your treatment. The treated nerves most often regrow within 6 months to a year. At that time, you may need repeat treatment.