In July of this year, Dr. Taylor Burnham joined Vivo Cura Health. You likely recognize the name – yep, the son of one Dr. Robert Burnham. Dr. T joins us from the University of Utah as an interventional physiatrist, where he has extensive experience in all injection techniques, but also brings some very solid research underpinnings to his practice – Yey!
Thus, at Vivo Cura we now have access to intra-discal procedures, cervical nerve blocks, upper cervical procedures and thoracic outlet syndrome options. But I’d first like to focus on a paper or two that Dr. T presented at last week’s IPSIS conference, which I previously touched on.
One of the challenges when working in an interventional clinic is determining how successful a procedure is, and what factors may contribute to that success. Dr. Robert Burnham has the largest database of outcomes for low back pain receiving radiofrequency neurotomy in the whole wide world. Radiofrequency coagulation (RFC) involves application of a thermal probe to the sensory nerves that supply the facet joints in the spine. The nerves are effectively coagulated, such that the messages arising from the facet joints do not reach the ascending spinal cord elements, and as such, the brain isn’t receiving messages that it interprets as pain.
What Is the Challenge?
How do you appropriately select people that will benefit? That is the question. A diagnostic block with local anaesthetic is the usual reference standard – with a short-term effect of pain relief usually associated with a good prediction of success with subsequent RFC. But is that one block, two blocks, 50% relief, 80% relief??? Dr. Robert Burnham’s database of 666 consecutive people was used as the basis to determine which paradigm resulted in better effects. In summary, 50% of people reported 50% pain and disability relief 3-months post-procedure, with employed patients twice as likely to experience pain relief. But the main finding here is that no significant difference in pain-related outcomes resulted based on block criteria. Thus, these results suggest that multiple block strategies, such as 50% pain relief after one block, might be employed to determine eligibility for RFC – that might lessen the burden on the health resources?
