Papers of the Week

Chronic axial neck pain (CANP) due to zygapophysial joint arthropathy is best diagnosed via cervical medial branch block (MBB). However, the paradigm by which MBB is used to select patients for cervical radiofrequency neurotomy (RFN) is contested. Dual diagnostic cervical MBB with a minimum of ≥80% pain relief to diagnose cervical zygapophysial joint pain has been accepted by some Medicare Local Coverage Determinations as the method for selecting patients for cervical RFN. There are some who would argue that the utility of the dual diagnostic MBB and the ≥80% pain relief cut off lacks utility in clinical practice. The suspicion being those who progress from MBB1 to MBB2 will then flow from MBB2 to RFN without fail. Does clinical practice using dual diagnostic MBBs and using an ≥80% pain relief cut off reduce patient eligibility for cervical RFN after both MBB1 and MBB2?