A discussion of the evidence-base for anesthetic nerve blocks as a tool to predict clinical outcomes following radiofrequency neurotomy for joint pain. The impact of nerve versus intra-articular block, number of blocks, anesthetic volume used, use of contrast agent, and variations in needle tip position will be reviewed.
Medial Branch Nerve Blocks: Evidence-Based Best Practices
Steven P. Cohen, MD
Lateral Branch Nerve Blocks: The Foundational Science and Elements Yet to be Defined
Byron Schneider, MD
Genicular Nerve Blocks: Developments Toward a More Accurate Protoco
Zachary McCormick, MD
- Review the current diagnostic and clinical outcome literature that addresses medial branch nerve blocks in order to selection patients for radiofrequency neurotomy in the treatment of refractory spinal pain of facet joint origin.
- Describe the foundational literature that defined an anesthetic block paradigm of the lateral branch nerves in order to anesthetize the posterior sacroiliac joint/dorsal ligaments, and discuss the need for a prognostic studies of lateral branch nerve blocks to determine if such block predict a positive outcome of radiofrequency denervation.
- Summarize the current state of the evidence for anesthetic genicular nerve blocks and the evolution in protocol optimization that is needed given a recently published anatomic study.
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