Randomized Study Assessing the Accuracy of Cervical Facet Joint Nerve (Medial Branch) Blocks Using Different Injectate Volumes

Abstract

Reducing the volume during cervical medial branch blocks may improve precision and accuracy.

A Randomized Comparison Between Ultrasound- and Fluoroscopy-Guided C7 Medial Branch Block

“…Second, although APost and lateral fluoroscopic views constitute the current imaging standards to assess contrast distribution after CMBB, computed tomography may be more sensitive for detection of aberrant spread. 12 Finally, despite randomization, an intergroup difference subsisted in terms of BMI. Because this difference was small, it is unlikely to have impacted our clinical findings.…”

Increasing the NaCl Concentration of the Preinjected Solution Enhances Monopolar Radiofrequency Lesion Size

“…30 In addition, injected volumes of 0.5 mL for medial branch blocks have been shown to spread to adjacent nontargeted tissue, including the neuroforamen. 31,32 Therefore, caution should be exercised when injecting fluids with high NaCl concentrations because of the possible risk of toxicity to nontargeted tissues, including central and peripheral nervous system structures.…”

A Prospective Validation of Biplanar Ultrasound Imaging for C5-C6 Cervical Medial Branch Blocks

“…Second, although anteroposterior and lateral fluoroscopic views constitute the current imaging standards to assess contrast distribution after CMBB, computed tomography may be more sensitive for detection of aberrant spread. 7 Finally, in our protocol, all blocks were performed by experienced operators; further studies are required to determine the minimal level of training needed for technical proficiency. 8 In conclusion, US guidance using a biplanar approach (and C7 TP as a sonographic landmark) constitutes a reliable imaging modality for C5-C6 medial branch blocks.…”