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Thread: Cervical medial branch block-yes or no?

  1. #11
    I have been having the blocks on my neck and back since march andthe ones on my back helped but this last one, a week and a half ago did the opposite. I really thought my pain couldn't get any worse but it did! My pain has been doubled since last wensday. I am wondering if the pain will decrease. I have never had this much pain after a procedure. Can anyone help?

  2. #12

    Medial branch block of facets

    Having MBB of facets in lower back done today for first time to see if will be candidate for radiofrequency. Fell on tailbone and pushed under a long time ago and now have one bulging disc, one slightly compressed disc (bone on bone), and have an extra vertebra too they think may be causing some problems. (guess I'm an alien with the extra vertebra) Have already tried phys. therapy, chiropractors, steroid injections and now doing this so hopefully this will work. My bones constantly sound like they are grinding and feel like they are moving in cracking, stabbing pains when I walk, sit or lie down. Feels like they are literally stabbing thru my skin. They thought it was an SI problem at first but now think its the facet joints. Its been going on for a couple of years now and I'm just getting worse. Had xrays on hips, back and MRIs and honestly my MRI of spine looks like it completely bow out really bad at the bottom but they said thats from my extra vertebra after the L5. I'm just clueless and aggravated. If this doesn't work, I don't know what to do. I don't ever want surgery and don't know if its even an option. I don't even know what to do next. If any one has any other ideas its greatly appreaciated. I'm not that old and I have a home daycare and still love playing with my kids, but have not even been able to run after them, play in the floor with them, swim with them, throw balls or anything.....Sorry, don't mean to whine and I know others are much much worse...just frustrated. Enjoy playing too much I guess

  3. #13
    Senior Member
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    I have had experience with an RFA of the L3/L4/L5 and S1 (left side only) and it worked wonderfully...lasted well over a year. Of course the nerves do grow back and I am scheduled for another one later this month. Oops, forgot to add...of course I had diagnostic facet injections prior to this...twice! I haven't had an RF done in my neck nor an ESI either. Years ago a PM wanted to do an RF in my cervical spine but I opted out mainly because I was told I needed a fusion anyway. And my PM will NOT do ESI's in the neck. Anyway, the majority of my issues are with the facets. Also, it is not uncommon to have an increase in pain after any injection or RF. The risks are there that much is true. One of them being permanent pain. But I risked it for the lumbar/sacral area and trust my PM...I have been with him for 8 years and because of all he has done I have been able to keep the meds low. I should clarify that I do NOT get injections ALL the time as in managing pain....only when there is a significant flare that will not calm down by any other means or meds. Anyway, the bottom line is...they ablate the medial branch nerve that lies across the facet. As my PM explained, it's sole purpose in life is to transmit pain signals and nothing else. He said it is about the size of a human hair and what he does is to ablate a portion that is about the size of a beebee. For lack of a better description he says just that small portion will interrupt or stop the pain signals yet not such a big portion as to cause neuromas form. I was worried about that too.

    Anyway, I had it done and I do NOT remember it! I was under conscious sedation and he says I was answering his questions and I know I was awake and talking. But for the life of me I do not remember what I said nor do I remember any pain at all.

    I think that it is probably an individual choice but it was one that was well worth it to me. Just make sure the doc spells everything out! I think I asked 1000 questions before he even did it. So, having well over a year's worth of relief was worth it to me. For the neck, I am not so sure. Knowing how my cervical spine is and how severe the pain used to be before any fusions, I might think twice about having an RF there although I know several people who have had significant relief. It is just that the neck is a far, far cry from the lumbar/sacral area.

  4. #14

    So I am to have a cervical medial branch block

    I noticed on this message board that this procedure is not effective in all cases and is a temporary fix. Is this correct or am I misreading? I am to have this procedure on Tuesday. I have had the epidural, been put on a bunch of meds, and trigger point injections. The meds take away some pain but leave me tired and I have 3 children ranging in ages from 6-10. I was doing last minute research on this procedure. I am having pain in my neck C-3/4 and C5/6. I have horrible headaches and occasional numbness in my right arm to my fingers. The Dr sais my nerves are inflamed and this would help. Is there any info you could give me on this procedure. Also if it is temporary and may not ease the pain.

    Thank you!

  5. #15

    (Cervical) Medial Branch Nerve Block Complications

    Just to let everyone know what I experienced at my last medial branch nerve block in the cervical areas 1-6. I've had multiple steroid injections to this area, about 5 in all. Yesterday I went in to have the first procedure for the branch nerve block performed. I was in an accident and have had pain with numbness to my arms and hands everyday for a couple years now. Everything was going fine with two doctors in the room performing the procedure and during the second injection to my C-2 area, I had the doctor ask if I was ok because my heart rate shot up to 130, (normally at 60 bpm). That's when the nightmare started. I tried to answer him but my voice was really low and I couldn't get the words out and then I started feeling nauseated and sweating profusely. I couldn't figure out why I felt this way because needles don't scare me and I do not get nervous during these procedures. It first felt that it was a vagal response and I was going to faint, but I never lost consciousness throughout this entire ordeal. I first noticed that I lost the ability to talk and then the ability to move. All of the sudden the doctor's voice was panic-stricken and I couldn't respond or move. Breathing was extremely hard and from my diaphragm only. I heard a nurse tell the doctor that my pulse rate was still climbing and my O2 sat's were 83% and falling. They turned me to my side and I could look around by couldn't move, breathe, or talk. I was totally paralyzed from my ears down. I had no gag reflex and my tongue would either stick out of my mouth or fall back and completely occlude my airway. I had zero control of my body, only my eyes. I could look at everyone's face as they called 911 and called for the "crash cart" which they use for full arrests. I am a healthy, fit, muscular, 200 lb. man that was now completely dead weight and had to be moved to my side and different positions. Depending on what position my tongue was in it would occlude my airway and it felt as if you placed a plastic bag over your face. I was "guppy breathing" since my diaphragm was the only muscle working. The other muscles to help expand my chest and lungs, such as the intercostal muscles, etc. were paralyzed. But my tongue was constantly falling back and occluding my airway, depending on what position they put me in and I couldn't communicate with the doctors and nurses in the room, on what was working to help me breathe and what wasn't. I had to wait until I was completely out of oxygen and wait for the O2 sensor to pick up that my levels were falling until they would know, which takes approx. 30 sec. to a minute, each time. I can't explain in this forum what kind of absolute hell this was and it lasted for 10-15 min. It felt as if I was going to die but kept getting just enough oxygen at certain brief moments to stay conscious. It felt as if someone tied me up so I couldn't move and kept placing a plastic bag over my face to the brink of losing consciousness, but then I wouldn't. It was hell to say the least. Twice I went into convulsions because of the lack of oxygen. I could hear the doctor asking the nurse if I had a seizure history, which I don't. I have seen hypoxic seizures before someone goes into respiratory arrest and I felt that was what I was doing because it was totally involuntary. I wouldn't call them seizures, because I was conscious throughout this whole ordeal. When the crash cart came and they inserted a NPA airway through my nose, which separated my tongue away from my esophagus, while they bagged me with a BVM, to breath for me, that I finally got some oxygen and could breathe half way normal. A couple minutes of this and I started to feel my feet again. Then I felt my arms and I could finally talk. I asked what they just gave me because I figured I went into anaphylatic shock and they must have given me epi and benedryl through the IV that they started when I was done convulsing after the first time. He told me that they didn't give me anything through my IV and then I could hear all the nurses and doctors breathe a sigh of relief. What they figured happened was that the doctor performing the injections in my neck, (a doctor or med student in training because this was a teaching hospital) might have advanced the needle too far and injected some of the local anesthetic (which is a high dosage but only 1/2 ml per injection) and it got into the membrane which covers the nerves that come out of the spinal column, that contain spinal fluid. The anesthetic then went into my spinal fluid and paralyzed me. The senior doctor said that he has done about 5-6 of these procedures, a week, for 20 years and has never seen anything like this. He also said that if it did get into my spinal fluid that he would of thought I would of been paralyzed for hours, not just the 15-20 min. that I was. I understand that accidents happen in medicine and in everything and I'm not upset about any of this. The doctors looked as scared as I was. But I am writing to everyone who is thinking about this procedure to let them know that this is still a risk and complication that has happened in the past and could happen again. Not to me, because I will never do this again. I would rather live in pain then to ever try this procedure again. I hope this will help shine some light on this very rare complication, but a complication and risk, nonetheless. If anyone has ever had something like this happen to them, or knows of someone who has experienced this type of complication, please respond to this thread. I would be interested in hearing your story.

  6. #16
    FireMedK,

    What a terrifying experience that must have been!!! Thank you for sharing what you had to go through. I sincerely hope you have no long-term problems from all of this. No, I sure wouldn't be trying it again myself, either.

  7. #17
    Quote Originally Posted by Prism33 View Post
    Just heard about this procedure yesterday so it's no surprise that I have the terminology wrong! A truck hit me in my driver's side 2 years ago and I have been in pain since, neck and lower back. The procedure as best as I can understand it at this moment - put simply- begins with an epedural (or similar) near the facet. If this works then it is followed with "burning" the nerves to make the fix permanent. The doc gave me an article by a Paul Dreyfuss, the heading reads, " Cervical, Thoracic, Lumbosacral Medial Branch Block". My previous diagnosis was myofacsial pain syndrome. Of course, like everyone else I want a fix not a temporary cover up!! One can hope!
    It sounds like ur on the right track...I have chrom myofacial pain from torn ligaments in the neck...its been two years...I am currently investigating medial branch block and botox injections...u prob want to look into botox injections as well

  8. #18

    Unhappy

    i am about to schedule my pre test for cervical medial branch block..... and I'm really scared! Ok lets start at the beginning... I was electrocuted back in july of last year and have had neck,arm,shoulder and lower back pain ever since. I was stuck in a rather awkward position for about 48hrs and I experienced tremors in my right hand and arm among other things. I have been getting trigger point injections for 5month now. They give me some relief but no longer than a week or so and I'm usually in pain and uncomfortable for a few days after but its worth the small time I get with no pain. I have been going to pt and ot for months now and they are getting to a point where they feel they can no longer help me i have a few more week left of both and I take muscle relaxers and narco for the pain, but try to keep those to a minimum cause otherwise I sleep all the time. So now my neuro wants to test me to see if a cervical medial brand block will help me... only problem is I am completely terrified of needles and it has taken all i have just to go in for the trigger points. I'm told i can't take any pain killers nor Valium... NOTHING!! So that doesn't help and I want to know more about what going to happen but when i'm in getting my TI I am so nervous that I don't think to ask a 100 questions. Can someone plz help! Oh I was diagnosed with myofacial pain syndrome and they also want to do botox which makes me nervous also.

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