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Effectiveness of lumbar facet joint blocks and predictive value before radiofrequency denervation: The Facet Treatment Study (FACTS), a randomized, controlled clinical trial

Anesthesiology Aug 17, 2018

Cohen SP, et al. - Researchers focused on the effectiveness of different lumbar facet blocks and their ability to predict radiofrequency ablation outcomes. They randomized 229 participants in a 2:2:1 ratio to receive intraarticular facet injections with bupivacaine and steroid, medial branch blocks, or saline. The second phase included participants in the intraarticular and medial branch block groups with a positive diagnostic block (50% or more relief) who experienced a negative outcome; these subjects underwent radiofrequency ablation, while all saline group individuals underwent ablation. Based on the findings, they concluded that facet blocks are not therapeutic. They observed higher responder rates in the treatment groups; this was suggestive of a presumption that facet blocks might offer prognostic value before radiofrequency ablation.
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