Journal CME Webinar: Diagnostic Medial Branch (Nerve to the Facet Joint) Block Treatment Paradigms prior to Lumbar Facet Radiofrequency Denervation

Join author, Steven Paul Cohen, M.D. for an informative discussion on his August, 2010 Journal ANESTHESIOLOGY article titled: "Multicenter, Randomized Comparative-Cost-Effectiveness Study Comparing 0, 1 and 2 Diagnostic Medial Branch (Facet Joint Nerve) Block Treatment Paradigms prior to Lumbar Facet Radiofrequency Denervation."

Overview
Success of interventional pain management techniques mainly depends on the correct use for the right patient. Lumbar facet radiofrequency denervation has been studied in 7 randomized controlled trials. Close examination of those studies confirms the statement that a better patient selection increases the success rate.

Diagnostic blocks are recommended to confirm the working diagnosis "facet joint pain" as well as the causative level. There are however several ways of performing those blocks. Intra-articular injections of local anesthetic, application of local anesthetic close to the medial branch of the dorsal ramus or repetitive medial branch blocks with local anesthetics with a different duration of action have all been used. Currently there is agreement that medial branch blocks are preferred over intra articular injections. There is still debate on the value of single blocks compared to double blocks. The article by Dr. Steven Paul Cohen provides interesting information on this subject. Results of the study will be presented along with the perspective of the findings of the randomized trials on the efficacy of lumbar facet radiofrequency denervation.

Objectives

At the conclusion of this webinar, the participant will have a clearer understanding of:

• Results of the study comparing cost per successful treatment after 0, 1 and 2 diagnostic medial branch blocks (presented by Steven Paul Cohen, M.D.)
• Correct use of diagnostic facet joint blocks and the outcome of radiofrequency treatment in RCT's and the influence on the interpretation of systematic reviews. (presented by Maarten van Kleef, M.D., Ph.D., FIPP)
• Economic considerations of facet joint blocks. (presented by James P.Rathmell, M.D.)

CME
The American Society of Anesthesiologists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The American Society of Anesthesiologists designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity. ASA will report credit to the American Board of Anesthesiologists with the ABA ID Number on record with ASA.

Presenters
Moderator - Jan Van Zundert, M.D., Ph.D., F.I.P.P., Ziekenhuis Oost-Limburg, Genk
Author - Steven Paul Cohen, M.D., Johns Hopkins School of Medicine
Panel Presenter - Maarten van Kleef, M.D., Ph.D., FIPP Maastricht University Medical Center, Dept Anesthesiology and Pain Management, Maastricht The Netherlands
Panel Presenter - James P.Rathmell, M.D., Massachusetts General Hospital/Harvard Medical School

About the Author

Steven P. Cohen. M.D. obtained his medical degree at the Mount Sinai School of Medicine in New York City, completed his anesthesiology residency at Columbia University, and a pain management fellowship at Massachusetts General Hospital. Currently, he is Associate Professor of Anesthesiology at the Johns Hopkins School of Medicine and the Uniformed Services University of the Health Sciences.  Dr. Cohen has been very active in teaching and pain research in recent years. His major contributions include pioneering the development of lateral branch radiofrequency denervation for treating sacroiliac joint pain, inventing the intravenous ketamine test, and performing the first studies evaluating the local administration of tumor necrosis factor inhibitors for pain treatment.  His recent work has also focused on improving pain care in wounded soldiers.  These include outcome data from the first pain clinic ever established in a combat zone, and conducting epidemiological studies evaluating a wide range of pain conditions, some of which have received international acclaim.  In addition to his academic work, Dr. Cohen is a Colonel in the Army Reserve, and serves as Chief, Anesthesia & Operative Services, at the 48th Combat Support Hospital at Fort Meade, and Director of Chronic Pain Research at Walter Reed Army Medical Center. 

About the Moderator

Jan Van Zundert, M.D. specialized in pain medicine after his training in anesthesiology. He obtained his PhD with his work on "The use of pulsed radiofrequency in the treatment of chronic pain". His main interest area's are the correct use of interventional pain management techniques. Therefore he relies on the one hand on the principles of Evidence-Based Medicine and on the other hand on the socio-economic principles where the global treatment cost as well as the part to be paid by the patient and third party payers are taken into consideration. Dr. Van Zundert is head of the multidisciplinary Pain Centre of the Hospital Oost Limburg, Genk, Belgium. He has a scientific affiliation with the Maastricht University Medical Centre, Maastricht, The Netherlands.

About the Panelists

James P. Rathmell, M.D. is chief of the Division of Pain Medicine in the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital and Associate Professor of Anesthesia at Harvard Medical School in Boston, Massachusetts.  He dedicates the majority of his time to patient care and the education of physicians specializing in pain medicine.  Much of his published work is based on the use of image-guidance to improve the safety of pain treatment, a subject area where he has published original research, reviews and major textbooks.  He serves on the editorial board of Anesthesiology and as Associate Editor-in-Chief of Regional Anesthesia and Pain Medicine.

Maarten van Kleef has practiced anaesthesiology since 1985. Since that date, he has been involved in interventional pain management. Together with Prof. dr. M. Sluijter, he has proceeded many studies to the efficacy of interventional procedures.
 
Dr. van Kleef is chairman and head of the department of Anaesthesiology and Pain Management at Maastricht University Medical Center. He is involved in training of residence and a member of the board of examination of the World Institute of Pain (WIP). His clinical and basal pain research department publishes more than 125 W1-publications on pain annually in interventional papers. Dr. van Kleef has served as chairman and co-chairman of several international congresses on pain.

Please note, when you register for this program, there will be a handout link at the bottom of your confirmation that takes you to 2 journal articles that are relative to this program.  Please be sure to click on this link when you receive your email.