Anaesthesia/Wiley Research Grant

The successful applicant for the Anaesthesia/Wiley Research Grant was:

Capturing the temporal course of reported pain and its relief from diagnostic facet joint blocks to inform the prediction of successful facet-joint denervation (FAST-facet study)

Dr Michael Lee

University of Cambridge

Amount
£48,364

Scientific Abstract
Chronic low back pain (CLBP) is currently the leading cause of disability globally. There are few specific, evidenced-based interventions for the condition. Of those, denervation of the lumbar facet joints (FJ) is deemed a cost-effective treatment option by National Institute of Clinical Excellence in the United Kingdom (UK). The contribution of the lumbar FJ to CLBP is determined by the degree of subjective pain relief obtained after selective local anaesthetic (LA) blocks of the medial branches (MBBs) of posterior primary rami that supply these joints. Research data suggest that cut-offs between 50%-80% pain relief from MBBs are diagnostic. These cutoffs are derived from contemporaneous pain ratings obtained before, and shortly after the MBBs. Applying the cut-offs in clinical practice requires that pain ratings are similarly acquired, which is challenging in the busy National Health Service. The project assesses a locally-designed and charity-funded digital technology (FAST) for obtaining pain ratings required for the diagnosis of 'facetogenic' pain, consistent with research studies. Data acquired during the project will be used to optimise the prognostic value of MBBs when longer term outcomes of lumbar FJ denervation are known in the longer term.