AAPM contributed to a multispecialty, international working group that recently published consensus practice guidelines on interventions for lumbar facet joint pain in Regional Anesthesia & Pain Medicine (RAPM), the official publication of the American Society of Regional Anesthesia and Pain Medicine (ASRA).
There are few conditions as controversial as lumbar facet blocks and radiofrequency ablation (RFA). Wide variation exists between views of pain medicine interventionalists and non-pain physicians on the effectiveness. Furthermore there is a lack of standards reflecting input from multiple pain organizations and other stakeholders for the use of lumbar facet block and RFA. The RAPM consensus practice guidelines are designed to guide clinical care, improve research quality, and assist payers with clinical practice pathways and authorization decisions.
Authors of the guidelines presented a 2-part symposium on February 28 in National Harbor during AAPM 2020 that is now available as an demand course in the AAPM Education Center.
Course learning objectives include:
- Review and improve selection criteria for “diagnostic” facet blocks.
- Assess how to maximize lesion size and its relationship to RF ablation success rate.
- Identify the issues surrounding patient selection for clinical practice and clinical trials.
The following recorded presentations and faculty members are covered in the course:
- Guideline Questions, Methodology and Patient Selection: How Many Blocks, Cutoff for a Positive Block, and Are Medial Branch or Intra-Articular Injections Better? —Steven P. Cohen, MD
- Imaging and Facet Pain: Evidence for Pre-Block Imaging and Imaging for the Performance Facet Blocks — W. Michael Hooten, MD
- What is the Evidence for Larger Lesions and Parallel Electrode Orientation? — David A. Provenzano, MD
- What Volume(s) Should be Used for Medial Branch Blocks and Intra-Articular Injections? — Jee Youn Moon, MD PhD FIPP CIPS
- Minimizing Complications with Lumbar Facet Blocks — Samer N. Narouze, MD PhD
- Should Facet Block Patients Routinely Be Sedated? — Robert W. Hurley, MD PhD FASA
- Differences Between Clinical Practice and Clinical Trials — Mark S. Wallace, MD
- Should a Trial of Conservative Care Be Mandatory Before Facet Blocks? — David J. Kennedy, MD
- Should Sensory and Motor Testing Be Used Before Radiofrequency Ablation? — Zirong Zhao, MD, PhD, FACP
AAPM members receive free access to this 2-part course, and nonmembers can purchase it for $49. Get started by logging into your AAPM account, or by creating an account if you do not yet have one. Contact Member Services for assistance at info@painmed.org or 847-375-4731.