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Cervical medial branch (MB) nerve anatomy. Cannula entry for cervical MB blocks and radiofrequency (RF) treatment (posterior approach). A 22-gauge, 10-cm SMK RF cannula with a 5-mm active tip is advanced in a plane 25 to 35 degrees caudal to the axial plane toward the midpoint between the superior articular process and inferior articular process of the target facet. This point appears as an invagination or “waist,” where the lateral margin of the facet column dips medially between articular surfaces. Note that treatment of the C3 third occipital nerve requires an additional cannula placed toward the superior aspect of the C3 articular pillar overlying the C2 to C3 facet joint. (Used with permission from and image courtesy of Dr. James Rathmell from Atlas of Image-Guided Intervention in Regional Anesthesia and Pain Medicine.5) Source: Cryoanalgesia and Radiofrequency Ablation, Principles and Practice of Pain Medicine, 3e Citation: Bajwa ZH, Wootton R, Warfield CA. Principles and Practice of Pain Medicine, 3e; 2016 Available at: http://mhmedical.com/ Accessed: May 03, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved
