What is the optimal block selection paradigm for predicting a successful treatment outcome following sacral lateral branch radiofrequency neurotomy? A real-world cohort study
Bibliographic record
Abstract
Background: Outcomes following sacral lateral branch radiofrequency neurotomy (SLBRFN) likely depend on patient selection criteria; however, commonly used criteria vary considerably. Refinement of selection criteria for SLBRFN may improve treatment outcomes. This study investigated common prognostic block-based selection criteria and treatment success following SLBRFN. Methods: In this retrospective cohort study, consecutive patients from two Canadian musculoskeletal pain management clinics who underwent SLBRFN over a 6-year period (2016-2022) were identified by electronic medical record. Patients were categorized according to several prognostic block paradigms based on number of blocks (single vs. dual), block type (lateral branch block [LBB] vs. intra-articular block [IAB]), and subsequent percentage of pain relief. Six block criteria were established: 1 = LBB/LBB≥80 %; 2 = IAB/LBB≥80 %; 3 = LBB/LBB 50-79 %; 4 = IAB/LBB 50-79 %; 5 = LBB≥80 %; 6 = LBB 50-79 %. Treatment success was assessed at three months post-SLBRFN using two criteria: (1) the primary study outcome of ≥50 % numerical rating scale (NRS) pain reduction and (2) a secondary outcome of Pain Disability Quality-of-Life Questionnaire (PDQQ) score improvement by the minimal clinically important difference (MCID). Logistic regression analyses evaluated the association between block criteria and treatment success following SLBRFN. Results: ) were included. Cohort success rates for pain and functional improvement were 43.4 % (95 % CI: 37.8-49.3) and 46.6 % (95 % CI: 40.9-52.5), respectively. After adjusting for demographics and cannula type/SLBRFN technique, none of the odds ratios for the six prognostic block paradigms showed statistical significance. Conclusion: Nearly 50 % of patients who underwent SLBRFN reported clinically significant improvement in pain and disability at three months post-procedure, regardless of prognostic block selection criteria. These results suggest that multiple block strategies may determine eligibility for SLBRFN.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".