Can ultrasound-guided medial branch blocks be used to select patients for cervical facet joint radiofrequency neurotomy? A matched retrospective cohort validation study.

Autor:	Burnham R; Central Alberta Pain and Rehabilitation Institute, Lacombe, Alberta T4L 2G5, Canada.; Vivo Cura Health, Calgary, Alberta T2E 2P5, Canada.; Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Alberta T5G 0B7, Canada., Trow R; Salmon Arm Pain Clinic, Salmon Arm, British Columbia V1E 3L4, Canada., Trow J; Department of Medicine, Royal College of Surgeons in Ireland University, Dublin D02 YN77, Ireland., Smith A; Vivo Cura Health, Calgary, Alberta T2E 2P5, Canada.; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta T2N 4N1, Canada., Burnham T; Vivo Cura Health, Calgary, Alberta T2E 2P5, Canada.; Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT 84132, United States.
Jazyk:	angličtina
Zdroj:	Pain medicine (Malden, Mass.) [Pain Med] 2024 Nov 01; Vol. 25 (11), pp. 671-674.
DOI:	10.1093/pm/pnae054
Abstrakt:	Background: Medial branch blocks are used to select patients for cervical facet joint radiofrequency neurotomy (CRFN). Blocks are typically performed under fluoroscopic guidance (ie, fluoroscopy-guided blocks [FLBs]). The validity of ultrasound-guided blocks (USBs) is not well established. No prior research has compared cervical USB validity and FLB validity with CRFN outcome used as the criterion standard. Objective: To evaluate cervical USB versus FLB validity with CRFN outcome used as the criterion standard. Methods: Demographic and outcome data were extracted from the electronic medical records of 2 affiliated musculoskeletal pain management clinics for all patients between 2015 and 2023 inclusive who had cervical USB leading to CRFN. CRFN outcomes of each USB patient were compared with those of a matched FLB patient from the radiofrequency neurotomy (RFN) outcome database of the same clinics. Matching variables included patient age, sex, pain duration, diagnostic/prognostic block paradigm, and CRFN number. Each patient completed a numeric rating scale (NRS) pain score and Pain Disability Quality-of-Life Questionnaire (PDQQ) just before and 3 months after CRFN. At repeat CRFN, patients provided a retrospective estimate of the duration and average magnitude (percentage) of relief after the CRFN. Results: USB and FLB groups were comprised of 27 patients (58 RFNs) and 38 patients (58 RFNs), respectively. Post-RFN NRS pain severity and PDQQ-Spine scores demonstrated comparable (P > .05) absolute improvements, proportion of patients achieving ≥50% improvement, and attainment of the minimum clinically important difference. Retrospective estimates of pain relief magnitude and duration were also comparable. Conclusions: This study finds cervical USB and FLB to be comparably valid as defined by their ability to predict CRFN outcome. Within the limitations of operator competence, USB can be used to select patients for CRFN. (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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