case_images: PMC3903800_01
case_images: Illustration of medial branch (MB) and lateral branch (LB) thoracic spine. Bogduk N (ed). Practice Guidelines for Spinal Diagnostics and Treatment Procedures. International Spine Injection Society (ISIS) 2004. Reproduced with permission of the publishers. PD: pedicle, VB: body of vertebra, SAP: superior articular process, LCL: lateral costovertebral ligament, LC: levator costorum, TP: transverse process, RB: rib, EI: external intercostal muscle, ZJ: zygaphophysial joint, VR: ventral root, SP: spinous process.
case_images: kjpain-27-43-g001.jpg
case_images: PMC3903800_01_kjpain-27-43-g001.jpg
case_images: F1
case_images: Unlike the lumbar medial branches, the course of the medial branch in the thoracic tends to be variable depending on the thoracic level (Fig. 1, 2). T4-T8 level, the medial branch is located in the soft tissue between the transverse process and therefore does not have as consistent skeletal landmark to place a radiofrequency cannula for ablation as other vertebral body levels (Fig. 1, 2). Two studies have used radiofrequency thermocoagulation (RFTC) of the medial branch for thoracic pain with moderate benefit.
case_images: Illustration of variation of position of medial branch in thoracic spine. Bogduk N (ed). Practice Guidelines for Spinal Diagnostics and Treatment Procedures,. International Spine Injection Society (ISIS) 2004. Reproduced with permission of the publishers.
case_images: kjpain-27-43-g002.jpg
case_images: PMC3903800_01_kjpain-27-43-g002.jpg
case_images: F2
case_images: Unlike the lumbar medial branches, the course of the medial branch in the thoracic tends to be variable depending on the thoracic level (Fig. 1, 2). T4-T8 level, the medial branch is located in the soft tissue between the transverse process and therefore does not have as consistent skeletal landmark to place a radiofrequency cannula for ablation as other vertebral body levels (Fig. 1, 2). Two studies have used radiofrequency thermocoagulation (RFTC) of the medial branch for thoracic pain with moderate benefit.