Effect of Medial Branch Block in Patients with Acute Cervical Injury or Whiplash Injury

Abstract

Objective: Acute and chronic pain caused by whiplash cervical injury can be very difficult to diagnose. Over the years, there were so many hypotheses about the cause, but, nowadays, zygopophyseal joint injury can be considered as main cause of aucte whiplash cervical injury. So, we evaluated the diagnostic importance and clinical prognosis by using minimal invasive treatment to the acute whiplash cervical patients without radiographic abnormality. Methods: Fourty-three consecutive patients, who underwent cervical pain without radiographic abnormality between July 2004 and December 2004, were included. But, patients having treatment since one week after injury and neurologic deterioration were excluded. The mean age of patients was 43.3 and Sex ratio was 1.59: 1 (M: F). We performed medial branch block (MBB), and decided the target as the center of articluar pillar including top and bottom levels. Results: Traffic accident, 19 cases (45. 74%), was main cause of acute whiplash cervical injury. Nuchal pain and shoulder pain are most common symptoms. C5-6 is most common site that MBB was performed. VAS of general activiy was decreased (7.65-> 3.04) within 1 month after operation, VAS of ambulation was also changed (8.16->2.6), pain VAS score was decreased (9.27-> 3.12). We experienced two complications totally, one is orthostatic disequilibrium and the other is presyncope with bradycardia. But, all complications were temporary and on the mend soon. Conclusion: MBB, minimal invasive treatment, can be considered as simple and safe method to improve clinical symptoms and life of quality in acute whiplash cervical injury patients.