title: Medial branch nerve block and ablation as a novel approach to pain related to vertebral compression fracture.
abstract: OBJECTIVE
  This review offers a critical examination of the biomechanical model that posits the posterior elements as a substantial contributor to pain in vertebral fracture. Further, the review assesses the treatment of posterior-element-associated pain in the setting of vertebral compression fracture in relation to vertebral augmentation.
  
  
  RESULTS
  In 2015, the only prospective randomized trial comparing percutaneous vertebroplasty with facet blockade was published in which authors found that percutaneous vertebroplasty produced better pain relief and function based on Oswestry Disability Index, Roland Morris Disability Questionnaire, and visual analog scale in the short term (≤1 week). However, differences in pain relief at 1 month and 12 months were not statistically significant.
  
  
  CONCLUSIONS
  The posterior elements may play a significant role in the pain generated after vertebral compression fractures. Treatment of the posterior element pain through medial branch radiofrequency ablation or facet injections may be another tool in providing analgesia in those with pain after vertebral compression fractures.
authors.affiliation: The Center for Pain Medicine UC Davis Health System, Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, University of California at Davis School of Medicine, Sacramento, California, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Solberg
authors.forename: David
authors.initials: D
authors.lastname: Copenhaver
authors.forename: Scott M
authors.initials: SM
authors.lastname: Fishman
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D000779:Anesthetics, Local / Q000627:therapeutic use; D050815:Fractures, Compression / Q000150:complications* / Q000601:surgery; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007270:Injections, Intra-Articular; D059352:Musculoskeletal Pain / Q000209:etiology / Q000628:therapy*; D009407:Nerve Block / Q000379:methods*; D016103:Spinal Fractures / Q000150:complications* / Q000601:surgery; D013127:Spinal Nerves / Q000187:drug effects / Q000601:surgery*; D054854:Vertebroplasty; D021801:Zygapophyseal Joint / Q000294:innervation
chemical_list: D000779:Anesthetics, Local; D005938:Glucocorticoids