Medial Branch Block (Facet Block):  This is a nerve block that is administered to a small nerve along the side of the spine.  The nerve connects with one to two spinal (facet) joints.  A needle is inserted along the side of the spine under the guidance of X-ray fluoroscopy.  The block is usually performed at more than one levels of the spine.  An anesthetic and/or anti-inflammatory agent is administered to the area.

            Sympathetic Nerve Block: This is a nerve block, which is administered to help identify whether there is pain arising from the sympathetic nerve chain.  A needle is inserted into the back under the guidance of fluoroscopy and is placed next to the vertebral body.  The block may be performed on either side of the spine.  An anesthetic agent is administered to the area.

Nerve Conduction Studies (NCS):

Nerve conduction studies (NCS) are typically performed as part of a needle electromyographic (EMG) examination.  The nerve conduction study is performed to evaluate the quality, speed and strength of nerve signal transmission.  To perform the test, superficial electrodes are placed upon the skin over the known course of a nerve.  The nerve is stimulated at designated locations with a handheld device, which produces a small electrical current.  The stimulus initiates the propagation of nerve impulses, which are recorded at the electrode site and transferred to a computer.

The study is used to help localize the site of nerve compromise and to quantify nerve signal characteristics.  The study can be used to detect the strength of the nerve signal, to evaluate the quality of the nerve signal and to quantify the speed of nerve signal transmission between designated points along its course.  NCS studies provide a valuable non-invasive method for evaluation and re-evaluating neurological compromise.