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Facet joint pain: Bogduk was among the first to recognize the role of facet joints as a source of spinal pain and contributed to the literature in anatomy, biomechanics, diagnosis, and therapeutics. He developed diagnostic and therapeutic techniques for facet joint pain, namely medial branch blocks and radiofrequency neurotomy.
Nerve blocks are injections that target specific nerves to serve as both therapeutic and diagnostic purposes. They have been used for a variety of neuropathic conditions including facet joint pain. Nerve block injections specifically targeted at the superior cluneal nerves are limited. [5]
Radiofrequency ablation or lesioning, also known as rhizolysis, can be used to give longer lasting relief by destroying the nerves that supply the facet joint (medial branch nerves). [9] Current guidelines as per the International Spine Intervention Society require two successful medial branch blocks before progressing to a radiofrequency ablation.
The fourth criterion clinches the diagnosis: pain relieved by injection of local anesthetic into the correct facet joint. This diagnostic procedure can also be therapeutic; the injection of steroids or radiofrequency denervation of the medial branch can be added for refractory cases.
Facet joint injections are used to alleviate symptoms of Facet syndrome. [1] The procedure is an outpatient surgery, so that the patient can go home on the same day. It usually takes 10–20 minutes, but may take up to 30 minutes if the patient needs an IV for relaxation. [ 2 ]
Cervical facet joint block – minor injections at the joints of the affected regions of the cervical spine; Media branch block and radio-frequency ablation – diagnosis and alleviation of pain from specific medial branches of the spinal nerve upon administering anaesthetics in the cervical region of interest to locate the area for treatment ...
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The dorsal ramus then turns to course posterior-ward before splitting into a medial branch and a lateral branch. Both these branches provide motor innervation to deep back muscles. In the neck and upper back, the medial branch is also responsible for providing sensory innervation of the skin; in the lower back, the lateral branch does so.