Table 24

Summary of agreement of committee members and partner societies

QuestionCommittee membersSocieties*†
Guidelines en bloc22 approved14 approved or supported, 1 disapproved
History and physical examination to identify painful atlanto–occipital and atlanto–axial joints22 approved15 approved, 0 disapproved
History and physical examination to identify painful cervical facet joints22 approved15 approved, 0 disapproved
Correlation of radiological studies with painful cervical facet joints22 approved15 approved, 0 disapproved
Requirement for conservative therapy before cervical facet blocks22 approved15 approved, 0 disapproved
Necessity of image guidance for cervical facet interventions22 approved15 approved, 0 disapproved
Technique, use of steroids and risk mitigation for atlanto–occipital and atlanto–axial joint injections22 approved15 approved, 0 disapproved
Technique for cervical facet blocks22 approved15 approved, 0 disapproved
Ideal volume for cervical facet blocks22 approved15 approved, 0 disapproved
Therapeutic value of cervical facet blocks22 approved15 approved, 0 disapproved
Limitations on laterality (bilateral vs unilateral) and number of levels for cervical facet interventions22 approved14 approved, 1 abstained
Diagnostic and prognostic value of cervical facet blocks22 approved15 approved, 0 disapproved
Effect of sedation on the validity of cervical facet blocks22 approved15 approved, 0 disapproved
Pain relief cut-off for designating a cervical facet block as positive21 approved, 1 disapproved14 approved, 1 disapproved
Number of facet blocks that should be performed before radiofrequency ablation21 approved, 1 disapproved14 approved, 1 disapproved
Orientation of electrodes for cervical medial branch radiofrequency ablation22 approved15 approved, 0 disapproved
Utility of sensory and motor stimulation during radiofrequency ablation22 approved14 approved, 1 disapproved
Utility of and means to create larger radiofrequency lesions22 approved15 approved, 0 disapproved
Risk mitigation for cervical facet interventions22 approved14 approved, 1 disapproved
Repeating radiofrequency ablation22 approved15 approved, 0 disapproved
Differences between clinical practice and clinical trials21 approved, 1 disapproved13 approved, 2 abstained
  • *North American Spine Society did not vote on any question.

  • †Since this document has neither been presented to nor approved by either the American Society of Anesthesiologists (ASA) Board of Directors or House of Delegates, it does not represent an official or approved statement or policy of the Society. Although the document is supported by the ASA, variances from the recommendations contained in the document may be acceptable based on the judgment of the responsible anesthesiologist. The Canadian Pain Society acknowledges that variances from the recommendations may be acceptable based on the judgment of the treating physician and that these guidelines do not represent an official policy from the Society.