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Medial Branch Block 腰椎背根内侧支神经阻滞 A medial branch nerve block is a type of injection used to determine if the facet joint is causing the patient's back pain. Facet joints are pairs of small joints between the vertebrae in the back of the spine. 腰椎背根内侧支神经阻滞是一种用于明确患者背部疼痛是否由关节突关节引起的一种注射方式。椎间关节是在脊柱背侧椎骨间的一对小关节。 The facet joints — also called zygapophysial joints — provide stability, while also allowing the spine to bend, flex, and twist. Each facet joint contains small nerves, called medial branch nerves, that carry pain signals from the facet joints to the brain. 关节突关节也叫做椎小关节，它提供脊柱稳定性，同时也允许其屈伸和扭转。每个关节突关节包含有叫做内侧支神经的小神经，它可将关节突关节疼痛的信号传达到大脑。 A variety of conditions can lead to inflammation of the facet joints, such as spinal stenosis or osteoarthritis, or from a trauma to the back, such as a car accident. If there is inflammation of the facet joints, the medial branch nerves will transmit pain signals to the brain. 许多状况可以导致关节突关节炎症，例如椎管狭窄、骨关节炎、以及车祸等引起的背部创伤。当关节突关节有炎症时，内侧支神经会将疼痛信号传到大脑。 A medial branch injection procedure begins with the patient laying face down on a table. The physician injects a local anesthetic, which numbs the skin and the tissue around the facet joint. 进行内侧支神经阻滞时，患者取俯卧位，医生注射局部麻醉药，从而使关节突关节附近的皮肤和组织麻木。 Next, the physician uses X-ray guidance, called fluoroscopy, to direct a small needle over the medial branch nerves. A small amount of contrast dye is injected to confirm that the medicine covers the medial branch nerve. Following this confirmation, a numbing medicine, called an anesthetic, is slowly injected onto each targeted nerve. 接着，医生使用Ｘ线透视引导，将穿刺针插到内侧支神经表面，注入少量的显影剂，证实药物覆盖内侧支神经。此后缓慢地向每一个目标神经注入称为局部麻醉药的可以引起麻木的药物。 Typically two adjacent medial branch nerves that travel at contiguous levels of the spine are injected in one procedure. 通常，在一次阻滞术中可以同时注射在脊柱相连节段穿行的两个相邻的内侧支神经。 If the patient experiences significant pain relief immediately after the injection, then the facet joint is determined to be the source of the patient's pain and the patient may be a candidate for a follow-up procedure, called a medial branch radiofrequency neurotomy, that may provide longer pain relief. 如果患者剧烈的疼痛在注射之后马上缓解，那么可以确定该关节突关节就是该患者疼痛的来源，作为后续治疗，患者可以进一步做内侧支神经射频切断术，这样可以更长时间缓解疼痛。 （高晨珉 转） |
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