2024 Consensus Working Group on Lumbar Facet Interventions in China and the United States. 2024 Consensus Guidelines on Lumbar Facet Interventions Among Practicing Pain Physicians in China and the United States[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(2): 294-302. DOI: 10.12290/xhyxzz.2024-0076
Citation: 2024 Consensus Working Group on Lumbar Facet Interventions in China and the United States. 2024 Consensus Guidelines on Lumbar Facet Interventions Among Practicing Pain Physicians in China and the United States[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(2): 294-302. DOI: 10.12290/xhyxzz.2024-0076

2024 Consensus Guidelines on Lumbar Facet Interventions Among Practicing Pain Physicians in China and the United States

Funds: 

National Key R&D Program of China 2022YFC3602205

More Information
  • Corresponding authors: YIN Yan1, E-mail: 347938055@qq.com
    WANG Lina2, E-mail: wangln@suda.edu.cn
    XU Jijun3, E-mail: xuj3@ccf.org
    1. Department of Pain Management, West China Hospital, Sichuan University, Chengdu 610041, China
    2. Department of Pain Management, First Affiliated Hospital of Suzhou University, Suzhou, Jiangsu 215006, China
    3. Department of Pain Management, Cleveland Clinic, Cleveland, OH 44195, USA

  • Received Date: February 02, 2024
  • Accepted Date: March 18, 2024
  • Issue Publish Date: March 29, 2024
  • Lumbar facet interventions, including facet joint injections, medial nerve blocks, and radiofrequency ablation (RFA), are prevalent treatments for low back pain (LBP). Despite their widespread use, debates persist regarding various aspects of these procedures. The 2024 Consensus Working Group on Lumbar Facet Interventions, composed of practicing pain physicians from both China and the United States, conducted an extensive review of the literature on the use of lumbar facet interventions in chronic pain management. Following the U.S. Preventive Services Task Force grading guidelines, this consensus provides an evidence-based, patient-centered guideline tailored for pain physicians at all expertise levels for the management of chronic lower spinal pain. The guideline offers detailed recommendations on the identification of facetogenic pain, criteria for patient selection, the application of lumbar facet blocks and RFA techniques, and strategies for the prevention and management of intervention-related complications.
  • [1]
    薛朝霞, 魏俊, 王祥瑞, 等. 脊神经后支相关性疼痛微创治疗技术中国疼痛科专家共识(2021版)[J]. 中华疼痛学杂志, 2021, 17(3): 228-238. DOI: 10.3760/cma.j.cn101658-20201012-00226

    Xue Z X, Wei J, Wang X R, et al. Experts consensus on minimally invasive therapy techniques for the treatment of pain related to posterior ramus of spinal nerve in China (2021)[J]. Chin J Painol, 2021, 17(3): 228-238. DOI: 10.3760/cma.j.cn101658-20201012-00226
    [2]
    中国康复医学会脊柱脊髓专业委员会, 中华医学会骨科学分会骨科康复学组. 中国非特异性腰背痛临床诊疗指南[J]. 中国脊柱脊髓杂志, 2022, 32(3): 258-268. DOI: 10.3969/j.issn.1004-406X.2022.03.09

    Spinal Cord Professional Committee of the Chinese Rehabilitation Medicine Association, Orthopedic Rehabilitation Group of the Orthopedic Branch of the Chinese Medical Association. Clinical guidelines for nonspecific low back pain in China[J]. Chin J Spine Spinal Cord, 2022, 32(3): 258-268. DOI: 10.3969/j.issn.1004-406X.2022.03.09
    [3]
    Perolat R, Kastler A, Nicot B, et al. Facet joint syndrome: from diagnosis to interventional management[J]. Insights Imaging, 2018, 9(5): 773-789. DOI: 10.1007/s13244-018-0638-x
    [4]
    Cohen S P, Bhaskar A, Bhatia A, et al. Consensus practice guidelines on interventions for lumbar facet joint pain from a multispecialty, international working group[J]. Reg Anesth Pain Med, 2020, 45(6): 424-467. DOI: 10.1136/rapm-2019-101243
    [5]
    Eldabe S, Tariq A, Nath S, et al. Best practice in radiofrequency denervation of the lumbar facet joints: a consensus technique[J]. Br J Pain, 2020, 14(1): 47-56. DOI: 10.1177/2049463719840053
    [6]
    Manchikanti L, Kaye A D, Soin A, et al. Comprehensive evidence-based guidelines for facet joint interventions in the management of chronic spinal pain: American Society of Interventional Pain Physicians (ASIPP) guidelines facet joint interventions 2020 guidelines[J]. Pain Physician, 2020, 23(3S): S1-S127.
    [7]
    Lee D W, Pritzlaff S, Jung M J, et al. Latest evidence-based application for radiofrequency neurotomy (LEARN): best practice guidelines from the American Society of Pain and Neuroscience (ASPN)[J]. J Pain Res, 2021, 14: 2807-2831. DOI: 10.2147/JPR.S325665
    [8]
    [9]
    Jackson R P, Jacobs R R, Montesano P X. 1988 Volvo award in clinical sciences. Facet joint injection in low-back pain. A prospective statistical study[J]. Spine (Phila Pa 1976), 1988, 13(9): 966-971. DOI: 10.1097/00007632-198809000-00002
    [10]
    Cohen S P, Hurley R W, Christo P J, et al. Clinical predictors of success and failure for lumbar facet radiofrequency denervation[J]. Clin J Pain, 2007, 23(1): 45-52. DOI: 10.1097/01.ajp.0000210941.04182.ea
    [11]
    Manchikanti L, Pampati V, Fellows B, et al. The inability of the clinical picture to characterize pain from facet joints[J]. Pain Physician, 2000, 3(2): 158-166.
    [12]
    Lilius G, Laasonen E M, Myllynen P, et al. Lumbar facet joint syndrome. A randomised clinical trial[J]. J Bone Joint Surg Br, 1989, 71(4): 681-684.
    [13]
    Dolan A L, Ryan P J, Arden N K, et al. The value of SPECT scans in identifying back pain likely to benefit from facet joint injection[J]. Br J Rheumatol, 1996, 35(12): 1269-1273. DOI: 10.1093/rheumatology/35.12.1269
    [14]
    Miyamoto G C, Lin C W C, Cabral C M N, et al. Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis[J]. Br J Sports Med, 2019, 53(3): 172-181. DOI: 10.1136/bjsports-2017-098765
    [15]
    Cohen S P, Moon J Y, Brummett C M, et al. Medial branch blocks or intra-articular injections as a prognostic tool before lumbar facet radiofrequency denervation: a multicenter, case-control study[J]. Reg Anesth Pain Med, 2015, 40(4): 376-383. DOI: 10.1097/AAP.0000000000000229
    [16]
    Van Zundert J, Vanelderen P, Kessels A, et al. Radiofre-quency treatment of facet-related pain: evidence and controversies[J]. Curr Pain Headache Rep, 2012, 16(1): 19-25. DOI: 10.1007/s11916-011-0237-8
    [17]
    Dreyfuss P, Stout A, Aprill C, et al. The significance of multifidus atrophy after successful radiofrequency neurotomy for low back pain[J]. PM R, 2009, 1(8): 719-722. DOI: 10.1016/j.pmrj.2009.05.014
    [18]
    Barbieri M, Bellini M. Radiofrequency neurotomy for the treatment of chronic pain: interference with implantable medical devices[J]. Anaesthesiol Intensive Ther, 2014, 46(3): 162-165. DOI: 10.5603/AIT.2014.0029
    [19]
    Rathmell J P, Manion S C. The role of image guidance in improving the safety of pain treatment[J]. Curr Pain Headache Rep, 2012, 16(1): 9-18. DOI: 10.1007/s11916-011-0241-z
    [20]
    Wu T, Zhao W H, Dong Y, et al. Effectiveness of ultrasound-guided versus fluoroscopy or computed tomography scanning guidance in lumbar facet joint injections in adults with facet joint syndrome: a meta-analysis of controlled trials[J]. Arch Phys Med Rehabil, 2016, 97(9): 1558-1563. DOI: 10.1016/j.apmr.2015.11.013
    [21]
    Manchikanti L, Pampati V, Damron K S, et al. The effect of sedation on diagnostic validity of facet joint nerve blocks: an evaluation to assess similarities in population with involve-ment in cervical and lumbar regions (ISRCTNo: 76376497)[J]. Pain Physician, 2006, 9(1): 47-51.
    [22]
    Cohen S P, Hameed H, Kurihara C, et al. The effect of sedation on the accuracy and treatment outcomes for diagnostic injections: a randomized, controlled, crossover study[J]. Pain Med, 2014, 15(4): 588-602. DOI: 10.1111/pme.12389
    [23]
    Wahezi S E, Alexeev E, Georgy J S, et al. Lumbar medial branch block volume-dependent dispersion patterns as a predictor for ablation success: a cadaveric study[J]. PM R, 2018, 10(6): 616-622. DOI: 10.1016/j.pmrj.2017.11.011
    [24]
    Moran R, O'Connell D, Walsh M G. The diagnostic value of facet joint injections[J]. Spine (Phila Pa 1976), 1988, 13(12): 1407-1410. DOI: 10.1097/00007632-198812000-00013
    [25]
    Cohen S P, Doshi T L, Constantinescu O C, et al. Effectiveness of lumbar facet joint blocks and predictive value before radiofrequency denervation: the facet treatment study (FACTS), a randomized, controlled clinical trial[J]. Anesthesiology, 2018, 129(3): 517-535. DOI: 10.1097/ALN.0000000000002274
    [26]
    Kennedy D J, Huynh L, Wong J, et al. Corticosteroid injections into lumbar facet joints: a prospective, randomized, double-blind placebo-controlled trial[J]. Am J Phys Med Rehabil, 2018, 97(10): 741-746. DOI: 10.1097/PHM.0000000000000960
    [27]
    Ackerman W E 3rd, Ahmad M. Pain relief with intraarti-cular or medial branch nerve blocks in patients with positive lumbar facet joint SPECT imaging: a 12-week outcome study[J]. South Med J, 2008, 101(9): 931-934. DOI: 10.1097/SMJ.0b013e31817e6ffb
    [28]
    Abbott Z, Smuck M, Haig A, et al. Irreversible spinal nerve injury from dorsal ramus radiofrequency neurotomy: a case report[J]. Arch Phys Med Rehabil, 2007, 88(10): 1350-1352. DOI: 10.1016/j.apmr.2007.07.006
    [29]
    Rambaransingh B, Stanford G, Burnham R. The effect of repeated zygapophysial joint radiofrequency neurotomy on pain, disability, and improvement duration[J]. Pain Med, 2010, 11(9): 1343-1347. DOI: 10.1111/j.1526-4637.2010.00923.x
    [30]
    Son J H, Kim S D, Kim S H, et al. The efficacy of repeated radiofrequency medial branch neurotomy for lumbar facet syndrome[J]. J Korean Neurosurg Soc, 2010, 48(3): 240-243. DOI: 10.3340/jkns.2010.48.3.240
    [31]
    Smuck M, Crisostomo R A, Trivedi K, et al. Success of initial and repeated medial branch neurotomy for zygapophysial joint pain: a systematic review[J]. PM R, 2012, 4(9): 686-692. DOI: 10.1016/j.pmrj.2012.06.007
    [32]
    Narouze S, Benzon H T, Provenzano D, et al. Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications (second edition): guidelines from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain[J]. Reg Anesth Pain Med, 2018, 43(3): 225-262.
    [33]
    Endres S, Shufelt A, Bogduk N. The risks of continuing or discontinuing anticoagulants for patients undergoing common interventional pain procedures[J]. Pain Med, 2017, 18(3): 403-409.
    [34]
    Burnham T, Hilgenhurst G, McCormick Z L. Second-degree skin burn from a radiofrequency grounding pad: a case report and review of risk-mitigation strategies[J]. PM R, 2019, 11(10): 1139-1142. DOI: 10.1002/pmrj.12143
    [35]
    Dobrogowski J, Wrzosek A, Wordliczek J. Radiofrequency denervation with or without addition of pentoxifylline or methylprednisolone for chronic lumbar zygapophysial joint pain[J]. Pharmacol Rep, 2005, 57(4): 475-480.
    [36]
    Manchikanti L, Malla Y, Wargo B W, et al. Complications of fluoroscopically directed facet joint nerve blocks: a prospective evaluation of 7, 500 episodes with 43, 000 nerve blocks[J]. Pain Physician, 2012, 15(2): E143-E150.
    [37]
    Smuck M, Crisostomo R A, Demirjian R, et al. Morphologic changes in the lumbar spine after lumbar medial branch radiofrequency neurotomy: a quantitative radiological study[J]. Spine J, 2015, 15(6): 1415-1421. DOI: 10.1016/j.spinee.2013.06.096
    [38]
    Smith C, DeFrancesch F, Patel J, et al. Radiofrequency neurotomy for facet joint pain in patients with permanent pacemakers and defibrillators[J]. Pain Med, 2019, 20(2): 411-412. DOI: 10.1093/pm/pny213
    [39]
    Gazelka H M, Welch T L, Nassr A, et al. Safety of lumbar spine radiofrequency procedures in the presence of posterior pedicle screws: technical report of a cadaver study[J]. Pain Med, 2015, 16(5): 877-880. DOI: 10.1111/pme.12678
  • Related Articles

    [1]Professional Panel on Injection Aesthetics, National Quality Control Center for Plastic and Aesthetic Surgery. Consensus of Chinese Experts on Neck Injection Aesthetics (2024 Edition)[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(6): 1289-1300. DOI: 10.12290/xhyxzz.2024-0617
    [2]ZHU Di, LUO Xufei, WANG Zijun, SHI Qianling, LI Haodong, WANG Ye, CHEN Yaolong. The Differences and Connections Among Expert Evidence, Expert Opinion and Expert Consensus in the Development of Guidelines[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(4): 936-941. DOI: 10.12290/xhyxzz.2024-0542
    [3]National Center for Quality Assurance of Anesthesia. 2023 Chinese Expert Consensus Statement for Prevention and Management of Perioperative Hypothermia[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 734-743. DOI: 10.12290/xhyxzz.2023-0266
    [4]Chinese Medicine Group, Clinical Epidemiology and Evidence-based Medicine Association of Chinese Medical Association. Expert Consensus on Clinical Research Methodology of Traditional Chinese Medicine in the New Era[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(5): 783-788. DOI: 10.12290/xhyxzz.2022-0428
    [5]Multi-disciplinary Team for Rare Diseases, Peking Union Medical College Hospital National Rare Diseases Committee. Expert Consensus on Clobazam in the Treatment of Refractory Epilepsy (2022)[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(5): 768-782. DOI: 10.12290/xhyxzz.2022-0421
    [6]Expert Consensus on Rapid SARS-CoV-2 Antigen Testing(2022)[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(3): 402-411. DOI: 10.12290/xhyxzz.2022-0195
    [7]YU Jiren, WANG E, WANG Difen, CANG Jing, FENG Yi, ZHANG Xijing, YANG Yi, YANG Yunmei, WU Shuijing, WANG Weijian, DU Bin, SHANG You, LIN Ru, CHENG Baoli, XIE Guohao, FANG Xiangming. Expert Consensus on Perioperative Management of Elderly Septic Patients (2021)[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(4): 481-489. DOI: 10.12290/xhyxzz.2021-0312
    [8]Sub-committee of Clinical Microbiology Laboratory, Chinese Hospital Association, XU Ying-chun, HU Ji-hong. Expert Consensus on Laboratory Testing for SARS-CoV-2[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 18-26. DOI: 10.12290/xhyxzz.2020-0046
    [9]Chinese Committee on Antimicrobial Susceptibility Testing, European Committee on Antimicrobial Susceptibility Testing, European Society of Clinical Microbiology and Infectious Diseases, Expert Committee on Infectious Diseases, China Medical Education Association, YANG Qi-wen, MA Xiao-ling, HU Fu-pin, ZHANG Jing, SUN Tong-wen, CHEN Bai-yi, XU Ying-chun, LIU You-ning. Expert Consensus on Polymyxin Antimicrobial Susceptibility Testing and Clinical Interpretation[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(5): 559-570. DOI: 10.3969/j.issn.1674-9081.2020.05.011
    [10]Yao-long CHEN, Xu-fei LUO, Ji-yao WANG, Xiao-qing LIU, Hong-cai SHANG, Ke-hu YANG. How to Distinguish between Clinical Practice Guidelines and Expert Consensus[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(4): 403-408. DOI: 10.3969/j.issn.1674-9081.2019.04.018
  • Cited by

    Periodical cited type(2)

    1. 仉培武,郭华,庞捷,白航航,樊立刚,李文言,吴楠,佘献玉,贺园. 单侧经皮椎体后凸成形术结合对侧脊神经后内侧支阻滞术治疗老年腰椎骨质疏松性椎体压缩骨折的疗效. 中华创伤杂志. 2024(08): 684-691 .
    2. 李丽芝,袁建蓉,彭红艳,陈金梅,王海慧,崔剑,刘蓓,聂发传. 下腰椎旁外向盲穿骶丛神经根阻滞用于慢性下肢疼痛治疗的安全性和有效性研究. 中华疼痛学杂志. 2024(06): 891-897 .

    Other cited types(0)

Catalog

    Article Metrics

    Article views (1728) PDF downloads (119) Cited by(2)
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return