Studies and reviews comparing lumbar medial branch blocks and intra-articular injections as prognostic tools before denervation therapy
| Study | Design/Study type | Number of patients | Diagnostic interventions | Results | Comments |
| Birkenmaier et al 145 | Randomized | 41, 26 (13 in each group) who had a positive block and received cryodenervation | MBB with 1 mL bupivacaine or pericapsular injections with 2 mL before lumbar facet cryodenervation | MBB>IA at 6 weeks and 3 months | Differences favoring MBB non-significant at 6 months. |
| Cohen et al 134 | Case-control | 511 who under MBB (n=212), IA (n=212) or MBB and IA (n=87) before RFA | MBB with 0.5–0.75 mL LA or IA with 0.5–1 mL LA+steroid | MBB>IA or MBB+IA at 3 months | In patients who received double-blocks, MBB>IA+MBB≥IA. |
| Cohen et al 18 | Two-phase, randomized | 228 who underwent prognostic blocks, 135 who received RFA | 0.5 mL MBB with LA and steroid, 0.5 mL IA injection or saline injection | Both MBB and IA >saline through 6 months, but no difference between MBB and IA injections | Those in the MBB and IA groups with a (+) prognostic block received RFA, while everyone in the saline group was treated. |
| van Zundert et al 142 | Narrative review | 7 randomized studies, 349 patients | Indirect comparison of studies using IA and MBB blocks as screening tests before RFA | MBB>IA as screening test before lumbar facet RFA | Did not perform meta-analysis. |
| Practice Guidelines, Bogduk, ed16 | Guidelines | Not noted | Indirect comparison of studies using IA and MBB blocks as screening tests before RFA | MBB>IA as screening test before lumbar facet RFA | Based on lack of validation for IA injections. |
IA, intra-articular; LA, local anesthetic; MBB, medial branch block; RFA, radiofrequency ablation