Efficacy of Interventional Procedures for Pain Control in Pediatric Patients with Central Sensitization of Pain

Purpose: Adolescent chronic spinal pain is an increasing global issue with no standardized treatment and lack of treatment data. Though interventional procedures in adults have been shown to be effective, limited studies have been reproduced in the pediatric population. The goal of this study was to examine the efficacy and safety of using medial branch blocks (MBB) for the relief of chronic spinal pain in adolescents. Methods: MBB patient records from June 2012 to April 2021 were reviewed for the following variables: Age, pain and functional disability inventory (FDI) scores, change in functionality, and complications. For patients with multiple MBB, each MBB was analyzed separately. T-tests were used for inferential analyses. All study procedures were approved by the Cook Children's Medical Center Institutional Review Board. Results: Seventy patients had 93 MBB: 50 had 1 MBB, 17 had 2 MBB, and 3 had 3 MBB. The median (range) age was 16.19 (9.36-18.86) years. Only the first and second MBB are examined further. Median pain scores significantly decreased after both first (5 vs. 0, P< 0.001) and second (4.5 vs. 0, P< 0.001) interventions. Median FDI scores significantly decreased after the first (22.5 vs. 12.5, P< 0.001), but not after the second (20.5 vs. 19, P=0.30), intervention. Improvements in functionality were attained for 85% and 80% of patients after interventions 1 and 2, respectively. Only 6 (6%) MBB resulted in minimal complications and side effects. Conclusion: Results suggest that MBB are efficacious and safe for pain relief and overall functional improvement in the pediatric population.