Diagnostic and Prognostic Anesthetic Blocks for Facet, Sacroiliac, and Knee Joint Pain: An Evidence-Based Update (202)

11:00 AM–12:00 PM Friday, February 28

This session discusses 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 Blocks: A Double-Edged Sword

Patricia Zheng

Lateral Branch Nerve Blocks: The Foundational Science and Elements yet to Be Defined

Byron Schneider

Genicular Nerve Blocks: Optimization for Accuracy and Inherent Limitations

Zachary McCormick

Learning Objectives:

  • Review the current diagnostic and clinical outcome literature that addresses medial branch nerve blocks in order to select 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 prognostic studies of lateral branch nerve blocks to determine if such blocks predict a positive outcome of radiofrequency denervation.
  • Review evidence updates for anesthetic genicular nerve blocks and the evolution in protocol optimization that is underway in current research efforts.