The Incidence of Intravascular Penetration in Medial Branch Blocks

Abstract

The false-negative rate for medial branch blocks is likely to be lower than previously reported. The rate of inadvertent intravascular injection for thoracic medial branch blocks is 0.7%. Cervical and lumbar medial branch blocks are associated with an overall rate of 3.9% and 3.7%, respectively. Although these rates are lower than previously reported, the incidence of false-negative blocks still justifies the use of contrast to confirm nonvascular injection.

Medial Branch Blocks or Intra-Articular Injections as a Prognostic Tool Before Lumbar Facet Radiofrequency Denervation

“…Whereas a false-positive block may decrease the success rate of RF denervation, a false-negative block can result in withholding an effective treatment from those who may benefit. Reasons for a false-negative MBB may include missing the target nerve, which is rarer in the lumbar than the cervical spine, 36,37 undetected vascular uptake (~5%), [38][39][40] and failure to distinguish procedure-related from baseline pain. For IA blocks, the "technical failure rate" is much higher than for MBBs 26 and the incidence of intravascular uptake is unknown.…”

Ultrasound-Guided Lumbar Medial Branch Block in Obese Patients

“…The reported average incidence of unintentional intravascular injection varies from 3.7% to 8%. 14,18 The volume of the local anesthetic and steroid that we used was only 0.3 mL for each of the nerves so the risk for complications was very small. None of our patients experienced any adverse events related to the procedure.…”

Omurga Hastalıklarının Tedavisinde Algoloğun Rolü

“…İnterlaminar enjeksiyonlar biraz daha güvenli gibi gözükmektedir (%1,9) (12). Aslında güvenli spinal girişim olmadığı bu nedenle de tüm girişimlerin görüntüleme rehberliğinde ve kontrast madde kontrolü ile yapılması gerektiği artık kabul görmüş bilimsel bir gerçektir (13,14). Her zaman mekanizma bilinmese de lokal anestezik ya da kortikosteroidlerin spinal kord hasarı yaparak ciddi komplikasyonlara neden olabilecekleri unutulmamalıdır (12).…”