Our team's proposal is designed to evaluate the available evidence regarding zygapophyseal (also known as “facet") mediated pain and interventional procedures. All five faculty involved are respected, academic Interventional Pain Medicine/Management (IPMM) physicians who strive to achieve the best possible outcomes for our patients, and we have a proven track record of working together to create a dynamic, interactive, and educational session at the 2016 AAPM&R Annual Assembly. This will be a case-based discussion and we will use the Audience Response System. We will discuss medial branch blocks, intra-articular facet joint injections (with and without steroids), and radiofrequency ablation (RFA). We will present the available evidence for performing these procedures in the cervical, thoracic, and lumbar spine. We will also discuss pre-test probability of successful denervation, the various approaches to and types of RFA (i.e. cooled RFA, traditional RFA, pulsed RF, etc.), and reliability of pain patterns. We believe that our session is applicable to all Physiatrists. We will strive to inform all of colleagues as to the availability and/or dearth of evidence related to each of these individual topics, and we will be able to call upon over 40 years of cumulative knowledge attained by our presenters. Our inclination will be towards presenting a critical review of available literature when it is available and to lean upon interactivity with the audience.

Learning Objectives

    • Describe situations in which it is appropriate to refer a patient for interventional management of facet-mediated pain.
    • Interpret imaging, historical data, and physical examination to establish a pre-test probability of successful pain relief and functional outcomes with interventional management of facet pain.
    • Adjust your practice patterns to improve overall safety of interventional procedures for facet pain.