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    Cervical medial branch block-yes or no?

    I have just begun research on the risks/benefits of a cervical medial branch
    block & neurotomy suggested by a new doctor. I would like to hear from
    others who have experienced this treatment for pain. Just found this site today so I may not be in the right place for this particular question. Thanks!

    #2
    Originally posted by Prism33
    I have just begun research on the risks/benefits of a cervical medial branch
    block & neurotomy suggested by a new doctor. I would like to hear from
    others who have experienced this treatment for pain. Just found this site today so I may not be in the right place for this particular question. Thanks!
    Prism33,

    Something is not right about your terminology. There is no such thing a "cervical medial branch". Are you sure that you are not talking about the median nerve? What kind of pain do you have? What kind of neurotomy is being proposed? In general, cutting of peripheral nerves does not eliminate pain and may aggravate peripheral nerve pain.

    Wise.

    Comment


      #3
      Anyone considering any type of ablative surgery for pain should be well acquainted with the risks and possible long-term complications. Don't count on getting this information from a doctor who's proposing it, he's too likely to gloss over it or simply be in denial of it. Among the posible problems are phantom pain, or a return of the pain, sometimes even worse than before, after what appeared at first to be a successful surgery.

      Comment


        #4
        Just heard about this procedure yesterday so it's no surprise that I have the terminology wrong! A truck hit me in my driver's side 2 years ago and I have been in pain since, neck and lower back. The procedure as best as I can understand it at this moment - put simply- begins with an epedural (or similar) near the facet. If this works then it is followed with "burning" the nerves to make the fix permanent. The doc gave me an article by a Paul Dreyfuss, the heading reads, " Cervical, Thoracic, Lumbosacral Medial Branch Block". My previous diagnosis was myofacsial pain syndrome. Of course, like everyone else I want a fix not a temporary cover up!! One can hope!

        Comment


          #5
          Originally posted by Prism33
          Just heard about this procedure yesterday so it's no surprise that I have the terminology wrong! A truck hit me in my driver's side 2 years ago and I have been in pain since, neck and lower back. The procedure as best as I can understand it at this moment - put simply- begins with an epedural (or similar) near the facet. If this works then it is followed with "burning" the nerves to make the fix permanent. The doc gave me an article by a Paul Dreyfuss, the heading reads, " Cervical, Thoracic, Lumbosacral Medial Branch Block". My previous diagnosis was myofacsial pain syndrome. Of course, like everyone else I want a fix not a temporary cover up!! One can hope!
          Prism33, I just looked it up the article by Paul Dreyfuss http://www.spineuniverse.com/display...ticle1178.html and did a literature search for medial branch block. According to the Dreyfuss article, the medial branches are tiny peripheral nerves that mediate the pain associated with facet joints in the spine.

          I found the following studies.

          Machikanti, et al. (2006) did a double-blind randomized trial of 60 patients segregated into four groups:
          • Group I. Control, medial branch blocks with bupivacaine
          • Group II. block with bupivacaine and Sarapin.
          • Group III. block with bupivacaine and betamethasone (a steroid)
          • Group IV. block with bupivacaine, Sarapin, and betamethasone.
          They found significant pain relieve at 3, 6, and 12 months. The duration of pain relieve was 13.4±3.5 weeks in the non-steroid group and 15.9±8 weeks in the steroid group. The average number of treatments was 3.8 in the non-steroid group and 3.4 times in the steroid group (no difference). This study does not rule out a placebo effect.

          In a second study, Manchikanti, et al. evaluated thoracic medial branch block and found that 71% of the patients showed >50% reduction in pain scores and that the percentage of patients was sustained for 36 months.

          Lindner, et al. (2006) studied 48 patients with chronic low back pain, using pulsed radiofrequency treatment. Amazingly, they found that 21/29 non-operated patients responded and 5/19 operated patients responded. Shim, et al. (2006) used ultrasound guided lumbar medial branch block with fluoroscopy control. The visual analog score fell from 52 to 16 after the block. Finally, Shin, et al. (2006) reported the radiofrequencey neurotomy of cervical medial branches resulted in 68% successful outcome.

          So, the treatment is not 100% effective but it seem help between 60-70% of people and for prolonged periods.

          Wise.

          References
          1. Manchikanti L, Damron K, Cash K, Manchukonda R and Pampati V (2006). Therapeutic cervical medial branch blocks in managing chronic neck pain: a preliminary report of a randomized, double-blind, controlled trial: clinical trial NCT0033272. Pain Physician 9: 333-46. BACKGROUND: Based on the criteria established by the International Association for the Study of Pain, the prevalence of persistent neck pain, secondary to involvement of cervical facet or zygapophysial joints has been described in controlled studies as varying from 54% to 67%. Intraarticular injections, medial branch nerve blocks and neurolysis of medial branch nerves have been described in managing chronic neck pain of facet joint origin. OBJECTIVES: To determine the clinical effectiveness of therapeutic cervical medial branch blocks in managing chronic neck pain of facet joint origin and to evaluate the effectiveness of the addition of Sarapin and steroids to local anesthetics. DESIGN: A double-blind, randomized, controlled trial. SETTING: An interventional pain management setting in the United States. METHODS: In this preliminary analysis, data from a total of 60 patients were included, with 15 patients in each of the 4 groups. Thirty patients were in a non-steroid group (combined Group I and II); and 30 patients were in a steroid group (combined Group III and IV). All of the patients met the diagnostic criteria of cervical facet joint pain by means of comparative, controlled diagnostic blocks. Four types of interventions were included. Group I served as control, receiving medial branch blocks using bupivacaine. Group II consisted of cervical medial branch blocks with bupivacaine and Sarapin. Group III consisted of cervical medial branch blocks with bupivacaine and betamethasone. Group IV consisted of cervical medial branch blocks with bupivacaine, Sarapin and betamethasone. OUTCOME MEASURES: Numeric pain scores, Neck Pain Disability Index, opioid intake, and work status were evaluated at baseline, 3 months, 6 months and 12 months. RESULTS: Significant pain relief (> or =50%), and functional status improvement was observed at 3 months, 6 months and 12 months. The average number of treatments for 1 year was 3.8 +/- 0.7 in the non-steroid group and 3.4 +/- 1.0 in the steroid group with no significant difference among the groups. Duration of average pain relief with each procedure was 13.4 +/- 3.5 weeks in the nonsteroid group, and it was 15.9 +/- 8.0 weeks in the steroid group with no significant difference among the groups. CONCLUSION: Therapeutic cervical medial branch nerve blocks, with or without Sarapin or steroids, may provide effective management for chronic neck pain of facet joint origin. Pain Management Center of Paducah, Paducah, KY, USA. drm@apex.net http://www.ncbi.nlm.nih.gov/entrez/q..._uids=17066118
          2. Manchikanti L, Manchikanti KN, Manchukonda R, Pampati V and Cash KA (2006). Evaluation of therapeutic thoracic medial branch block effectiveness in chronic thoracic pain: a prospective outcome study with minimum 1-year follow up. Pain Physician 9: 97-105. BACKGROUND: The prevalence of persistent upper back and mid back pain due to involvement of thoracic facet joints has been described in controlled studies as varying from 43% to 48% based on IASP criteria. Therapeutic intraventions utilized in managing chronic neck pain and low back pain of facet joint origin include intraarticular injections, medial branch nerve blocks, and neurolysis of medial branch nerves by means of radiofrequency. These interventions have not been evaluated in managing chronic thoracic pain of facet joint origin. OBJECTIVE: To determine the clinical effectiveness of therapeutic thoracic medial branch blocks in managing chronic upper back and mid back pain of facet joint origin. DESIGN: A prospective outcome study. SETTING: Interventional pain management setting in the United States. METHODS: Fifty-five consecutive patients meeting the diagnostic criteria of thoracic facet joint pain by means of comparative, controlled diagnostic blocks were included in this evaluation. All medial branch blocks were performed in a sterile operating room under fluoroscopic visualization with mild sedation with midazolam and/or fentanyl. Statistical methods incorporated intent-to-treat analysis. OUTCOME MEASURES: Numeric pain scores, significant pain relief > or = 50%), Oswestry Disability Index, work status and Pain Patient Profile (P-3). Significant pain relief was defined as an average 50% or greater reduction of numeric pain rating scores. RESULTS: The results showed significant differences in numeric pain scores and significant pain relief (50% or greater) in 71% of the patients at three months and six months, 76% at 12 months, 71% at 24 months, and 69% at 36 months, compared to baseline measurements. Functional improvement was demonstrated at one year, two years, and three years from baseline. There was significant improvement with increase in employment among the patients eligible for employment (employed and unemployed) from baseline to one year, two years, and three years (61% vs 96% to 100%) and improved psychological functioning. CONCLUSION: Therapeutic thoracic medial branch blocks were an effective modality of treatment in managing chronic thoracic pain secondary to facet joint involvement confirmed by controlled, comparative local anesthetic blocks. Pain Management Center of Paducah, Kentucky 42003, USA. drm@apex.net http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16703969
          3. Lindner R, Sluijter ME and Schleinzer W (2006). Pulsed radiofrequency treatment of the lumbar medial branch for facet pain: a retrospective analysis. Pain Med 7: 435-9. BACKGROUND: The use of pulsed radiofrequency (PRF) for treatment of the medial branch is controversial. STUDY DESIGN: A retrospective study of the results of PRF treatment of the medial branch in 48 patients with chronic low back pain was carried out. Patients who did not respond were offered treatment with conventional radiofrequency heat lesions. PATIENT MATERIAL: Patients were included who had low back pain and >50% pain relief following a diagnostic medial branch block. The mean age was 53.1 +/- 13.5 years, the mean duration of pain was 11.4 +/- 10.9 years (range 2-50). Nineteen patients had undergone surgery. METHODS: Pain scores on a numeric rating scale of 1-10 were noted before and after the diagnostic nerve block, before the procedure, and at 1-month and 4-month follow-up. PRF was applied for 2 minutes at a setting of 2 x 20 ms/s and 45 V at a minimum of two levels using a 22G electrode with a 5 mm active tip. Heat lesions were made at 80 degrees C for 1 minute. OUTCOME DEFINITION: A successful outcome was defined as a >60% improvement on the numeric rating scale at 4-month follow-up. RESULTS: In 21/29 nonoperated patients and 5/19 operated patients, the outcome was successful. In the unsuccessful patients who were subsequently treated with heat lesions, the success rate was 1/6. CONCLUSION: The setup of our study does not permit a comparison with the results of continuous radiofrequency (CRF) for the same procedure, other than the detection of an obvious trend. When comparing our results with various studies on CRF of the medial branch such a trend could not be found. Based on these retrospective data, prospective and randomized trials, for example, radiofrequency vs PRF are justified. Department of Anesthesiology, Intensive Care and Pain Treatment, The Swiss Paraplegic Center, Nottwil, Switzerland. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=17014603
          4. Shim JK, Moon JC, Yoon KB, Kim WO and Yoon DM (2006). Ultrasound-guided lumbar medial-branch block: a clinical study with fluoroscopy control. Reg Anesth Pain Med 31: 451-4. BACKGROUND AND OBJECTIVES: For diagnostic lumbar medial-branch blocks, fluoroscopic guidance is considered mandatory, but this technique comes with radiation exposure. The clinical feasibility of the ultrasound-guided lumbar medial-branch block has been demonstrated. We evaluated the success rate and validity of this new method by use of fluoroscopy controls in patients previously diagnosed with lumbar facet joint-mediated pain. METHODS: In 20 patients, 101 lumbar medial-branch blocks were performed under ultrasound guidance. The target point was the groove at the cephalad margin of the transverse process adjacent to the superior articular process. C-arm fluoroscopy was performed afterward to confirm the needle position. Pain scores were assessed by use of visual analog scale (VAS 0 to 100). RESULTS: All 101 needles were placed in the correct lumbar segment. Ninety-six of the 101 needletips were in the correct position with a success rate of 95%. Two needles were associated with intravascular spread of the contrast dye. VAS score was reduced from 52 to 16 after the block. CONCLUSIONS: Ultrasound-guided lumbar medial-branch blocks can be performed with a high success rate. However, to be completely independent from fluoroscopy controls, this technique requires further studies regarding the detection of intravascular spread. Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16952818
          5. Shin WR, Kim HI, Shin DG and Shin DA (2006). Radiofrequency neurotomy of cervical medial branches for chronic cervicobrachialgia. J Korean Med Sci 21: 119-25. Chronic neck and arm pain or cervicobrachialgia commonly occurs with the degeneration of cervical spine. Authors investigated the usefulness of radiofrequency (RF) neurotomies of cervical medial branches in patients with cervicobrachialgia and analyzed the factors which can influence the treatment outcome. Demographic data, types of pain distribution, responses of double controlled blocks, electrical stimulation parameters, numbers and levels of neurotomies, and surgical outcomes were evaluated after mean follow-up of 12 months. Pain distribution pattern was not significantly correlated with the results of diagnostic blocks. Average stimulation intensity was 0.45 V, ranging from 0.3 to 0.69, to elicit pain response in cervical medial branches. The most common involvement of nerve branches was C4 (89%), followed by C5 (82%), C6 (75%), and C7 (43%). Among total of 28 patients, nineteen (68%) reported successful outcome according to outcome criteria after 6 months of followup (p=0.001), and eight (42%) of 19 patients reported complete relief (100%) of pain. Four patients showed recurrence of pain between 6 and 12 months. It was therefore concluded that cervical medial branch neurotomy is considered useful therapeutic modality for the management of cervicobrachialgia in selected patients, particularly in degenerative zygapophyseal disorders. Department of Neurosurgery, Presbyterian Medical Center, Jeonju, Korea. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16479077

          Comment


            #6
            Wow! Thank you for doing the research! Hopefully, I'll have time tomorrow to go through it very carefully. This is all new to me so it will take some work to digest it all. I very much appreciate it. Hopefully, someone that has experienced this will speak up as well.

            Comment


              #7
              Dear Dr. Young,

              Thank you for taking the time to comment on MBB. I have had personal experience with this, but not for my central pain. It was rather for a cervical facet syndrome which presumably had to do with multiple vertebrectomies, fusions, and who knows what else. In other words, it was mechanical and not for nociceptive pain, although CP hyperpathia certainly can upgrade noxious events, even if neuropathy is not causative.

              Anyone who has wrestled will find the experience of MBB extraordinary. Although I have no physical activity and have not for years, my neck muscles kept bending the needle. It took many passes and a very long time and a bigger needle. You are awake of course and it is a very big needle--(ten feet long and one foot thick, more or less, come to think of it, maybe an 18 or 20 gauge, about six inches or so. big enough to start an IV in a rhinoceros). It requires some considerable endurance of pain. The injecting needle goes inside the trochar so it is not a picnic. The CT fluoro does not look as comforting as those ergonomic graceful circles, there seemed to be pieces of dried blood all over it--I have no idea what it was, but probably it was dried blood. The radiologist had a neat trick for the local. He added a little bicarb to the mix which took away the sting of the local. That was the least he could do considering he was sticking the giant needle in my neck. Actually I wonder why more docs don't do that. He blocked the MBB and also hit the facet zone, the actual facets have disappeared. In my case they did it six times. (three levels, bilat) All injections involved both a local anesthetic and kenalog. I got about three hours of remarkable relief and about two months of significant relief. I was not prepared for the mental side effects of the kenalog. It caused me to think I was going crazy. Of course, I think my total was something like 200 mg. of Kenalog. At that dose, the steroids affect your thinking and if you have not been forewarned, you will wonder what is happening to you. I retained water for three months afterward. I suspect my glucose tolerance test would have been abnormal for at least a year.

              I felt the block was worth it for diagnostic purposes, to rule out a neuropathic etiology, and to avoid yet another worrhless surgery, but the relief was short lived. I learned that a medical faculty member had had the epidural version of the block just a month before and had died on the table from vasospasm. I kept my injection at the medial branch and did not ask them to see if an epidural dose would give better or more long lasting relief, so I cannot speak to that and do not wish to assume the risk.

              I have seen doctors who attempt to freeze the medial branch with a cryoprobe and then went back in. The nerve regrows in a year no matter how it is destroyed, so I am very skeptical of reports claiming 36 months relief from injection.

              My neuroradiologist said docs in the pain clinic were probably only hitting the medial branch about 30% of the time because there was no CT fluoro, however, he knew of a radiologist who had gotten so good at them that he could do them without any imaging, just by feel. This was the result of long years of doing it under CT fluoro until he had the feel of each layer.

              P.S. If you have this done, ask about CT fluoroscopy, since the accuracy is good. There is more radiation, which you would have to consider.

              That is my two cents. Thank you again for the literature references.
              Last edited by dejerine; 15 Feb 2007, 8:56 PM.

              Comment


                #8
                the word nociceptive is a typo. It should read the MBB was NOT done for neuropathic pain. The server wont' let me edit my original.

                Comment


                  #9
                  My hubby had his first cervical medial branch block procedure today....
                  hmmmm..not sure about this procedure and the one that is suppose to follow it and be up to 3-6 months of relief from pain for him. He is just trying to hold out on the 6 hrs the doc asked and not take any pain meds....but he is in pain....I say to heck with it take a pain pill...but I don't like pain! His pain is in his neck and shoulders from cancer(head & neck)...he has had numerous operations,chemo,radiation...(adenocarcinoma of salivary glands and submandibular carcinoma.)
                  He is stable at this point but we never kid ourselves with this very aggressive and invasive nasty cancer....but we never quit fighting it either!
                  He had steroid shots the last few weeks and it gave him some relief.
                  He also has been trying some muscle relaxers and he says they are helping.
                  Any input would be helpful.... Thanks!

                  Comment


                    #10
                    I'd like some kind of nerve block that would provide some relief to my shoulder blade areas. Does such a block exist?
                    Alan

                    Proofread carefully to see if you any words out.

                    Comment


                      #11
                      I have been having the blocks on my neck and back since march andthe ones on my back helped but this last one, a week and a half ago did the opposite. I really thought my pain couldn't get any worse but it did! My pain has been doubled since last wensday. I am wondering if the pain will decrease. I have never had this much pain after a procedure. Can anyone help?

                      Comment


                        #12
                        Medial branch block of facets

                        Having MBB of facets in lower back done today for first time to see if will be candidate for radiofrequency. Fell on tailbone and pushed under a long time ago and now have one bulging disc, one slightly compressed disc (bone on bone), and have an extra vertebra too they think may be causing some problems. (guess I'm an alien with the extra vertebra) Have already tried phys. therapy, chiropractors, steroid injections and now doing this so hopefully this will work. My bones constantly sound like they are grinding and feel like they are moving in cracking, stabbing pains when I walk, sit or lie down. Feels like they are literally stabbing thru my skin. They thought it was an SI problem at first but now think its the facet joints. Its been going on for a couple of years now and I'm just getting worse. Had xrays on hips, back and MRIs and honestly my MRI of spine looks like it completely bow out really bad at the bottom but they said thats from my extra vertebra after the L5. I'm just clueless and aggravated. If this doesn't work, I don't know what to do. I don't ever want surgery and don't know if its even an option. I don't even know what to do next. If any one has any other ideas its greatly appreaciated. I'm not that old and I have a home daycare and still love playing with my kids, but have not even been able to run after them, play in the floor with them, swim with them, throw balls or anything.....Sorry, don't mean to whine and I know others are much much worse...just frustrated. Enjoy playing too much I guess

                        Comment


                          #13
                          I have had experience with an RFA of the L3/L4/L5 and S1 (left side only) and it worked wonderfully...lasted well over a year. Of course the nerves do grow back and I am scheduled for another one later this month. Oops, forgot to add...of course I had diagnostic facet injections prior to this...twice! I haven't had an RF done in my neck nor an ESI either. Years ago a PM wanted to do an RF in my cervical spine but I opted out mainly because I was told I needed a fusion anyway. And my PM will NOT do ESI's in the neck. Anyway, the majority of my issues are with the facets. Also, it is not uncommon to have an increase in pain after any injection or RF. The risks are there that much is true. One of them being permanent pain. But I risked it for the lumbar/sacral area and trust my PM...I have been with him for 8 years and because of all he has done I have been able to keep the meds low. I should clarify that I do NOT get injections ALL the time as in managing pain....only when there is a significant flare that will not calm down by any other means or meds. Anyway, the bottom line is...they ablate the medial branch nerve that lies across the facet. As my PM explained, it's sole purpose in life is to transmit pain signals and nothing else. He said it is about the size of a human hair and what he does is to ablate a portion that is about the size of a beebee. For lack of a better description he says just that small portion will interrupt or stop the pain signals yet not such a big portion as to cause neuromas form. I was worried about that too.

                          Anyway, I had it done and I do NOT remember it! I was under conscious sedation and he says I was answering his questions and I know I was awake and talking. But for the life of me I do not remember what I said nor do I remember any pain at all.

                          I think that it is probably an individual choice but it was one that was well worth it to me. Just make sure the doc spells everything out! I think I asked 1000 questions before he even did it. So, having well over a year's worth of relief was worth it to me. For the neck, I am not so sure. Knowing how my cervical spine is and how severe the pain used to be before any fusions, I might think twice about having an RF there although I know several people who have had significant relief. It is just that the neck is a far, far cry from the lumbar/sacral area.

                          Comment


                            #14
                            So I am to have a cervical medial branch block

                            I noticed on this message board that this procedure is not effective in all cases and is a temporary fix. Is this correct or am I misreading? I am to have this procedure on Tuesday. I have had the epidural, been put on a bunch of meds, and trigger point injections. The meds take away some pain but leave me tired and I have 3 children ranging in ages from 6-10. I was doing last minute research on this procedure. I am having pain in my neck C-3/4 and C5/6. I have horrible headaches and occasional numbness in my right arm to my fingers. The Dr sais my nerves are inflamed and this would help. Is there any info you could give me on this procedure. Also if it is temporary and may not ease the pain.

                            Thank you!

                            Comment


                              #15
                              (Cervical) Medial Branch Nerve Block Complications

                              Just to let everyone know what I experienced at my last medial branch nerve block in the cervical areas 1-6. I've had multiple steroid injections to this area, about 5 in all. Yesterday I went in to have the first procedure for the branch nerve block performed. I was in an accident and have had pain with numbness to my arms and hands everyday for a couple years now. Everything was going fine with two doctors in the room performing the procedure and during the second injection to my C-2 area, I had the doctor ask if I was ok because my heart rate shot up to 130, (normally at 60 bpm). That's when the nightmare started. I tried to answer him but my voice was really low and I couldn't get the words out and then I started feeling nauseated and sweating profusely. I couldn't figure out why I felt this way because needles don't scare me and I do not get nervous during these procedures. It first felt that it was a vagal response and I was going to faint, but I never lost consciousness throughout this entire ordeal. I first noticed that I lost the ability to talk and then the ability to move. All of the sudden the doctor's voice was panic-stricken and I couldn't respond or move. Breathing was extremely hard and from my diaphragm only. I heard a nurse tell the doctor that my pulse rate was still climbing and my O2 sat's were 83% and falling. They turned me to my side and I could look around by couldn't move, breathe, or talk. I was totally paralyzed from my ears down. I had no gag reflex and my tongue would either stick out of my mouth or fall back and completely occlude my airway. I had zero control of my body, only my eyes. I could look at everyone's face as they called 911 and called for the "crash cart" which they use for full arrests. I am a healthy, fit, muscular, 200 lb. man that was now completely dead weight and had to be moved to my side and different positions. Depending on what position my tongue was in it would occlude my airway and it felt as if you placed a plastic bag over your face. I was "guppy breathing" since my diaphragm was the only muscle working. The other muscles to help expand my chest and lungs, such as the intercostal muscles, etc. were paralyzed. But my tongue was constantly falling back and occluding my airway, depending on what position they put me in and I couldn't communicate with the doctors and nurses in the room, on what was working to help me breathe and what wasn't. I had to wait until I was completely out of oxygen and wait for the O2 sensor to pick up that my levels were falling until they would know, which takes approx. 30 sec. to a minute, each time. I can't explain in this forum what kind of absolute hell this was and it lasted for 10-15 min. It felt as if I was going to die but kept getting just enough oxygen at certain brief moments to stay conscious. It felt as if someone tied me up so I couldn't move and kept placing a plastic bag over my face to the brink of losing consciousness, but then I wouldn't. It was hell to say the least. Twice I went into convulsions because of the lack of oxygen. I could hear the doctor asking the nurse if I had a seizure history, which I don't. I have seen hypoxic seizures before someone goes into respiratory arrest and I felt that was what I was doing because it was totally involuntary. I wouldn't call them seizures, because I was conscious throughout this whole ordeal. When the crash cart came and they inserted a NPA airway through my nose, which separated my tongue away from my esophagus, while they bagged me with a BVM, to breath for me, that I finally got some oxygen and could breathe half way normal. A couple minutes of this and I started to feel my feet again. Then I felt my arms and I could finally talk. I asked what they just gave me because I figured I went into anaphylatic shock and they must have given me epi and benedryl through the IV that they started when I was done convulsing after the first time. He told me that they didn't give me anything through my IV and then I could hear all the nurses and doctors breathe a sigh of relief. What they figured happened was that the doctor performing the injections in my neck, (a doctor or med student in training because this was a teaching hospital) might have advanced the needle too far and injected some of the local anesthetic (which is a high dosage but only 1/2 ml per injection) and it got into the membrane which covers the nerves that come out of the spinal column, that contain spinal fluid. The anesthetic then went into my spinal fluid and paralyzed me. The senior doctor said that he has done about 5-6 of these procedures, a week, for 20 years and has never seen anything like this. He also said that if it did get into my spinal fluid that he would of thought I would of been paralyzed for hours, not just the 15-20 min. that I was. I understand that accidents happen in medicine and in everything and I'm not upset about any of this. The doctors looked as scared as I was. But I am writing to everyone who is thinking about this procedure to let them know that this is still a risk and complication that has happened in the past and could happen again. Not to me, because I will never do this again. I would rather live in pain then to ever try this procedure again. I hope this will help shine some light on this very rare complication, but a complication and risk, nonetheless. If anyone has ever had something like this happen to them, or knows of someone who has experienced this type of complication, please respond to this thread. I would be interested in hearing your story.

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